Background: The attempt to manage patients with acute myeloid leukemia as outpatients has become increasingly common due to high hospitalization costs, low availability for beds and patient preference. Publications on the subject are scarce, especially in low-income regions and the safety in this population remains to be determined. The present study aims to assess the safety of consolidation with high-dose cytarabine in the outpatient setting. Materials and Methods: We retrospectively analyzed 39 patients who underwent consolidation with highdose cytarabine, between 2009 and 2018, at Ophir Loyola Hospital, in Belém, Brazil. Patients treated after 2015 were given high-dose cytarabine as outpatients due to the decision of medical staff. Results: Twenty-seven patients received 76 cycles of cytarabine as outpatients; males were 48.14% of the total population, with a median age of approximately 45 years. The occurrence of delay between cycles was significantly lower among outpatients (48.14% vs. 83.33%, p = 0.04). There was no difference in relapse rates, transfusion requirements and non-relapse mortality between both groups. Hospitalization was required in 40.74% of patients during outpatient cycles and 18.51% of blood cultures were positive for pathogens. Nonrelapse mortality was significantly higher among patients above 50 years old and treated on an outpatient basis (44.4% vs. 5.60%, p = 0.03). Conclusion: High-dose cytarabine administration on an outpatient basis appears to be safe and effective in a low-income population at the Brazilian Amazon region, but toxicity seems to be increased for patients older than 50 years.

Therapy guidelines for acute leukemias (ALs) have focused on an arbitrary age cut-off as a guide for intensity of therapy. However, treatment outcomes depend on more important prognostic factors, such as performance status (PS) and the presence of comorbidities. This study aims to evaluate clinical scales as predictors of mortality in patients with acute leukemia during intensive induction therapy. This prospective cohort study included all patients diagnosed with Acute Myeloid Leukemia (AML) or Acute Lymphoblastic Leukemia (ALL) who received induction treatment at Ophir Loyola Hospital (HOL) in Belém-PA, from February 2018 to February 2019. The following scales were assessed: Eastern Cooperative Oncology Group (ECOG), Haematopoetic Cell Transplantation Comorbidity Index (HCT-CI), Cumulative Illness Rating Scale (CIRS), Charlson Comorbidity Index (CCI), Adult Comorbidity Evaluation 27 (ACE-27), Katz and Lawton scales, G8 Questionnaire and Mini Nutritional Assessment (MAN). The median age of the 40 patients included was 37 years old (range, 19-65) and sex distribution was equal. Univariate analysis showed that higher age (OR = 5.74, p 0.024), ACE 27 >0 (OR = 5.7, p 0.003) and HCT-CI >0 (OR = 3.87, p 0.02) were contributing factors to 40-day mortality, but no meaningful association was noticed with the other scales. Therefore, this study reaffirms the significant impact of comorbidities on the survival of patients with AL, suggesting that comorbidity assessment may be extremely helpful for making decisions on intensive induction therapy.