((Rami Komrokji, MD))
Some larger institutions are conducting IPOP administration more frequently, but there are some elements to consider before proceeding with this treatment plan, such as patient- and disease-related factors and the institution’s infrastructure.
It is important to assess whether the patient's disease is in proliferative status or they have neutropenia or any other major comorbidities, as these factors would likely remove them as candidates for IPOP administration.
In addition, for our institution, patients with renal failure are typically excluded from IPOP treatment with VYXEOS.
Another consideration for IPOP is that the patient should be able to stay local for induction on Days 1, 3, and 5 of treatment prior to planned admission.
The institution must also have the necessary infrastructure to support an IPOP approach, which may include daily monitoring and transfusion support, with blood transfusions given as needed.
Daily monitoring may include clinical evaluation and blood tests, such as complete blood count, comprehensive metabolic panel, and uric acid and phosphorus levels.
Typically, patients will spend a half day in the infusion center and be given fluids for hydration and other supportive treatments as needed.
VYXEOS is indicated for the treatment of newly-diagnosed therapy-related acute myeloid leukemia (t‑AML) or AML with myelodysplasia-related changes (AML-MRC) in adults and pediatric patients 1 year and older.
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