Original Research

Feasibility of Outpatient High-Dose Methotrexate Infusions in Pediatric Patients With B-Lineage Acute Lymphoblastic Leukemia

Joy L. Bartholomew, APRN, Hongying Dai, PhD, Keith J. August, MD, MS, Robin E. Ryan, MPH, and Kristin A. Stegenga, PhD, RN, CPON

Children’s Mercy Hospital Kansas City, Kansas City, Missouri

Authors’ disclosures of conflicts of interest are found at the end of this article.

Joy L. Bartholomew, APRN, Children’s Mercy Hospital Kansas City, 2401 Gillham Road, Kansas City, MO 64108. E-mail: joyb@cmh.edu


J Adv Pract Oncol 2018;9(4):381–386 | https://doi.org/10.6004/jadpro.2018.9.4.2 | © 2018 Harborside™


  

ABSTRACT

Abstract

High-dose methotrexate (MTX) given in four hospitalizations during interim maintenance for high-risk pediatric B-lineage acute lymphocytic leukemia significantly improves survival but increases resource utilization. Children remain hospitalized for intravenous hydration and blood or urine monitoring until MTX clearance parameters are reached. Improved supportive care, extended infusion center hours, and pediatric home health expertise afford alternatives to prolonged hospital admissions, potentially offering quality, cost-effective approaches that positively impact the delivery of care.




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