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Background: Several international centres have published their experiences with outpatient autologous stem cell transplantation (ASCT) as treatment of haematological malignancies. Aim: In this single‐centre retrospective review, we aim to examine the outcomes of outpatient autograft and review healthcare resource utilisation in the pre‐cytopenic period. Methods: Patients undergoing ASCT in Royal Hobart Hospital, Tasmania between 2008 and 2018 had their records reviewed and key outcomes data collected based on whether they received inpatient/outpatient ASCT. An outpatient ASCT was defined as conditioning as an outpatient; patients could then be managed with an elective admission during the cytopenic period or admission only when clinically indicated. Results: Of 231 ASCT performed, 135 (58%) were as outpatients: 59 used carmustine‐etoposide‐cytarabine‐melphalan conditioning for lymphoma (BEAM‐ASCT) and 76 used high‐dose melphalan for myeloma and amyloidosis (MEL‐ASCT). Approximately one‐third of patients undergoing outpatient ASCT were admitted electively during nadir period; the majority of patients required minimal interventions prior to this time. The most common causes for unplanned hospitalisation (which occurred in 71 (80%) of the 89 planned outpatient transplants) were febrile neutropenia (39%) and mucositis (35%). Age was the only risk factor identified to increase risk of requiring unplanned hospitalisation. Use of oral antibiotic prophylaxis reduced febrile neutropenia rates among melphalan outpatient ASCT. Outpatient ASCT led to significantly reduced inpatient bed‐days and overall cost (approximately A$13 000–A$16 000) compared with inpatient autografts, with no significant differences in engraftment, rates of febrile neutropenia, intensive care admissions or mortality. Conclusion: Outpatient autografts may save healthcare resources without compromising patient outcomes. [ABSTRACT FROM AUTHOR]

The article presents information about medication safety issues, medication errors and strategies to prevent medication errors drawn from Australian incidents and US experiences. A discussion of medication errors and potential medication errors regarding human error and drug labeling errors is presented. Safety briefs on prescription drugs and safe practice recommendations are offered.

Aim: Etoposide is used in a wide variety of solid and hematological tumors. It is available in Australia in two intravenous formulations; etoposide base and the etoposide phosphate salt with 113.6 mg of etoposide phosphate being equivalent to 100 mg of the etoposide base. Variances between the etoposide dose prescribed and that actually given have been reported recently in Australia with patients receiving either too much or too little of the intended dose of etoposide. We carried out a review of national practices of prescribing, dispensing and labeling of etoposide and etoposide phosphate. Methods: Cancer care clinicians and pharmacists, identified through their membership of the Clinical Oncological Society of Australia (COSA), were asked to complete an online survey or participate in a telephone interview, about their etoposide prescribing and dispensing practices. Results: Nineteen pharmacists and 11 prescribers provided responses suitable for analysis. The most common reason for using the etoposide phosphate formulation was its shorter infusion time. The most common reason provided for preferring the base formulation over the phosphate formulation was that the original clinical trial data supported its use. There were a variety of methods identified that a prescriber might use to indicate the formulation of etoposide required and a variety of methods used for the labeling of etoposide formulations. Conclusion: Prescribing, ordering and dispensing practices for etoposide base and etoposide phosphate are inconsistent across Australia, which could lead to dosing errors. We recommend that a national standard is adopted with etoposide phosphate preparations prescribed and labeled as “Etoposide (as the PHOSPHATE) x mg. Where x is the number of milligrams of etoposide base required.” This would move towards minimizing the risk of dosage errors occurring with these formulations. [ABSTRACT FROM AUTHOR]

The article focuses on the Australian and New Zealand Urogenital and Prostate Cancer Trials Group, a comprehensive cooperative trials groups for genitourinary oncology. Information about several trials conducted by the group are included including a single-arm phase II trial of an accelerated regimen of bleomycin, etoposide and cisplatin, a randomised study of radiation adjuvant, and combined induction and maintenance regimen of BCG vaccine and mitomycin.