(91) From hospital to home: Our outpatient Blinatumomab journey

Title: From hospital to home: Our outpatient Blinatumomab journey

Abstract : Beginning in 2019, pediatric B-cell ALL patients were randomized to receive Blinatumomab which was given to patients in 2-3 cycles of a continuous 28-day infusion. This 28-day infusion required a lengthy inpatient hospital stay for the patient and family/caregiver(s). In July 2024, Blinatumomab became the standard of care for a majority of pediatric B-cell ALL patients drastically increasing the number of patients who would be receiving the infusion. As a result, the Center for Cancer and Blood Disorders team at Manning Family Children’s Hospital determined there would be a need to implement an outpatient program for those patients to receive Blinatumomab infusions at home. This outpatient program was formed not only due to the increase in patients receiving treatment but also to provide the patients and their families/caregiver(s) the ability to go about their daily lives at home while receiving the infusions. Following review of the standard of care change, a clinical task force comprised of the program’s Senior Director of Patient Care Services, 2 Attending Physicians, a Nurse Practitioner, the Hematology/Oncology Clinical Supervisor, the Inpatient Clinical Director, and the Hematology/Oncology Clinical Pharmacist was formed and met over a 4-month period to discuss, develop, and establish the outpatient Blinatumomab protocol. A multifaceted action plan was made and implemented that included infusion pump selection, provider and patient guideline development, a staff education plan, caregiver education/engagement, protocol builds, home supply needs, home monitoring protocol, and an unexpected admission protocol. This outpatient program implementation resulted in increased patient satisfaction for those patients who chose to do outpatient home Blinatumomab infusions.