For patients receiving outpatient venetoclax/azacitidine who develop profound neutropenia with ANC <200, do you admit for monitoring during the nadir in the absence of fever?

I don't think I would admit these patients. My recommendation would be to monitor temperature daily or feel febrile and let the clinic know if they have any symptoms of localizing infection. The NCCN and IDSA guidelines talk that only neutropenic patients with fever, even amongst those who have the low-risk disease (NCCN or MASCC score) can be treated outpatient (but in reality, the patient population is very small in my limited experience). (Freifeld et al., PMID 21258094)

If we admit all these...

I do not routinely admit my neutropenic patients on outpatient HMA/Ven treatment in the absence of fever or other evidence of active infection. Patients should avoid acetaminophen, if able to, and monitor their temperature. If they develop a fever of 38.0C or higher for one hour or 38.3C or higher at any time, they should present to the hospital for admission for work-up and treatment of febrile neutropenia.