Table 1

AUS rule variables and homecare eligibility criteria

AUS ruleYesNo
Preceding chemotherapy more intensive than ALL maintenance10
Total white cell count <0.3×109/L10
Platelet <50×109/L10
Minimum observation period (if clinically stable and fulfil homecare criteria)
4–8 hours4–24 hours24 hours48 hours
Eligibility criteria for homecare
Disease status: leukaemia/lymphoma in remission (as per last bone marrow aspirate or solid tumour stable/responding (as per oncologist)
Low-risk disease group:
NOT ANY OF—ALL induction, or acute infant leukaemias, acute myeloid leukaemia, postallogeneic haematopoietic stem cell transplant within 3 months or still on immunosupression, congenital immunodeficiency, aplastic anaemia, Down syndrome
Centres may have particular local concerns about other specific diagnosis
No confirmed focus of infection requiring inpatient care*
No medical complication requiring inpatient care†
No severe sepsis at FN presentation‡
Availability of a 24-hour caregiver
Good education of patient and carer on reportable symptoms
Availability of a telephone
Within 1 hour of treating hospital
Treating team preference
No previous history of non-compliance with medical care
  • Variations may consider excluding ANY patient who has received a fluid bolus, or had a past unplanned admission to ICU. If well, presence of infiltrates on CXR may not be a contraindication to oral antibiotic therapy.

  • At the time of writing, SARS-CoV2/COVID-19-positive swabs should NOT NECESSARILY be a contraindication to homecare.

  • *Including, but not limited to, central venous access device site infection, cellulitis, perianal cellulitis or pain, significant pneumonia, infection with multidrug-resistant bacteria.

  • †Including, but not limited to, pain requiring intravenous analgesia, poor oral intake or excessive loss requiring intravenous hydration; respiratory distress or oxygen requirement.

  • ‡Severe sepsis includes any of (i) altered conscious state, (ii) inotrope requirement, (iii) fluid bolus requirement >40 mL/kg or (iv) respiratory support requirement.

  • ALL, acute lymphoblastic leukaemia; AUS, Australian-UK-Swiss; CXR, chest X-ray; FN, febrile neutropenia; ICU, intensive care unit.