Dr Patel-Donnelly on Factors Influencing Consolidation Therapy in Hematologic Malignancies

Dipti Patel-Donnelly, MD, oncologist, assistant professor, oncology, Johns Hopkins University, discusses key factors to consider when selecting an appropriate consolidation therapy for the management of high-risk hematologic malignancies in community practice.

For patients undergoing intensive treatment for hematologic malignancies, deciding on the optimal consolidation strategy is pivotal and requires careful consideration, Patel-Donnelly begins. After completing initial induction therapy, which often involves hospitalization and intensive care for complex cases, patients and their families work with the medical team to determine the most suitable approach for consolidation, she expands.

Factors influencing this decision include the patient's clinical course during induction therapy, Patel-Donnelly states. Patients who experience significant complications may be recommended for inpatient consolidation to ensure close monitoring and management of potential complications, she explains. Conversely, patients whose disease responded well to treatment with minimal complications and have strong family support may be considered for outpatient consolidation. Outpatient consolidation offers more flexibility, allowing patients to recover at home while still requiring frequent visits to the treatment center for follow-up and monitoring, Patel-Donnelly adds.

Logistics and accessibility also play a crucial role in the decision-making process, Patel-Donnelly continues, adding that patients must live within reasonable proximity to the treatment center and have reliable transportation to attend frequent follow-up appointments. Moreover, outpatient consolidation may be preferred to reduce the risk of hospital-acquired infections, which can often occur during prolonged hospital stays. Although outpatient consolidation provides patients with more freedom and comfort, it necessitates diligence in adhering to medication schedules, recognizing potential signs of complications, and promptly seeking medical attention when needed, Patel-Donnelly says.

Ultimately, the goal of consolidation therapy is to further treat the disease, reduce the risk of recurrence, and optimize patient comfort and outcomes, Patel-Donnelly emphasizes. The choice between inpatient and outpatient consolidation is tailored to individual patient circumstances, treatment response, and support structures available. This personalized approach ensures comprehensive care throughout a patient’s treatment, prioritizing effective approaches while minimizing risks and enhancing patient well-being, she concludes.