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Caring for terminal patients in haematology: the urgent need of a new research agenda

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Abstract

Although major therapeutic advances have led to improved survival for many hematologic malignancies in recent years, survival remains poor for some disease subtypes and a substantial proportion of patients are ultimately destined to die from their disease and/or related complications. Despite this, there is evidence that patients are not always referred to palliative/home care services as often as those with other cancers, although this situation may be improving in some areas. More research is needed, however, to explore reasons for this and identify whether patients may consequently have unmet needs that impact on their quality of life at this time.

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References

  1. Joske D, McGrath P (2007) Palliative care in haematology. Int Med J 37:589–90. doi:10.1111/j.1445-5994.2007.01438.x

    Article  CAS  Google Scholar 

  2. Niscola P, Tendas A, Scaramucci L et al (2013) End of life care in hematology: still a challenging concern. Ann Palliat Med 3:7–11

    Google Scholar 

  3. Howell DA, Roman E, Cox H et al (2010) Destined to die in hospital? Systematic review and meta-analysis of place of death in haematological malignancy. BMC Palliat Care 9:9

    Article  PubMed Central  PubMed  Google Scholar 

  4. Smith A, Roman E, Howell D et al (2010) The Haematological Malignancy Research Network (HMRN): a new information strategy for population based epidemiology and health service research. Br J Haematol 148:739–53

    Article  PubMed Central  PubMed  Google Scholar 

  5. Howell DA, Wang H-I, Roman E et al (2014) Variations in specialist palliative care referrals: findings from a population-based patient cohort of acute myeloid leukaemia, diffuse large B-cell lymphoma and myeloma. BMJ Support Palliat Care. doi:10.1136/bmjspcare-2013-000578, bmjspcare–2013–000578

    PubMed  Google Scholar 

  6. Niscola P, Cartoni C, Romani C et al (2007) Epidemiology, features and outcome of pain in patients with advanced hematological malignancies followed in a home care program: an Italian survey. Ann Hematol 86:671–6. doi:10.1007/s00277-007-0296-4

    Article  PubMed  Google Scholar 

  7. McGrath P (1999) Palliative care for patients with hematological malignancies—if not, why not? J Palliat Care 15:24–30

    CAS  PubMed  Google Scholar 

  8. Howell DA, Wang H-I, Smith AG et al (2013) Place of death in haematological malignancy: variations by disease sub-type and time from diagnosis to death. BMC Palliat Care 12:42

    Article  PubMed Central  PubMed  Google Scholar 

  9. Efficace F, Cartoni C, Niscola P et al (2012) Predicting survival in advanced hematologic malignancies: do patient-reported symptoms matter? Eur J Haematol 89:410–6. doi:10.1111/ejh.12004

    Article  PubMed  Google Scholar 

  10. Kripp M, Willer A, Schmidt C et al (2014) Patients with malignant hematological disorders treated on a palliative care unit: prognostic impact of clinical factors. Ann Hematol 93:317–25. doi:10.1007/s00277-013-1861-7

    Article  CAS  PubMed  Google Scholar 

  11. Cheng BHW, Sham MMK, Chan KY, et al. (2013) Intensive palliative care for patients with hematological cancer dying in hospice. Analysis of the level of medical care in the final week of life. Am J Hosp Palliat Med; 1049909113512412 doi:10.1177/1049909113512412

  12. Tang ST, Wu S-C, Hung Y-N et al (2009) Determinants of aggressive end-of-life care for Taiwanese cancer decedents, 2001 to 2006. J Clin Oncol Off J Am Soc Clin Oncol 27:4613–8. doi:10.1200/JCO.2008.20.5096

    Article  Google Scholar 

  13. McGrath P, Leahy M (2009) Catastrophic bleeds during end-of-life care in haematology: controversies from Australian research. Support Care Cancer Off J Multinatl Assoc Support Care Cancer 17:527–37. doi:10.1007/s00520-008-0506-1

    Google Scholar 

  14. Manitta V, Zordan R, Cole-Sinclair M et al (2011) The symptom burden of patients with hematological malignancy: a cross-sectional observational study. J Pain Symptom Manag 42:432–42. doi:10.1016/j.jpainsymman.2010.12.008

    Article  Google Scholar 

  15. Fadul NA, El Osta B, Dalal S et al (2008) Comparison of symptom burden among patients referred to palliative care with hematologic malignancies versus those with solid tumors. J Palliat Med 11:422–7

    Article  PubMed  Google Scholar 

  16. Tendas A, Niscola P, Ales M et al (2009) Disability and physical rehabilitation in patients with advanced hematological malignancies followed in a home care program. Support Care Cancer 17:1559–60. doi:10.1007/s00520-009-0732-1

    Article  PubMed  Google Scholar 

  17. Howell DA, Shellens R, Roman E et al (2011) Haematological malignancy: are patients appropriately referred for specialist palliative and hospice care? A systematic review and meta-analysis of published data. Palliat Med 25:630–41

    Article  PubMed  Google Scholar 

  18. Corbett CL, Johnstone M, Trauer JM et al (2013) Palliative care and hematological malignancies: increased referrals at a comprehensive cancer centre. J Palliat Med 16:537–41. doi:10.1089/jpm.2012.0377

    Article  PubMed  Google Scholar 

  19. Niscola P, de Fabritiis P, Cartoni C et al (2006) Home care management of patients affected by hematologic malignancies: a review. Haematologica 91:1523–9

    PubMed  Google Scholar 

  20. Niscola P, Tendas A, Giovannini M et al (2012) Transfusions at home in patients with myelodysplastic syndromes. Leuk Res 36:684–8. doi:10.1016/j.leukres.2012.01.010

    Article  PubMed  Google Scholar 

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The authors declare no conflict of interest.

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Correspondence to Pasquale Niscola.

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Niscola, P., Tendas, A., Giovannini, M. et al. Caring for terminal patients in haematology: the urgent need of a new research agenda. Support Care Cancer 23, 5–7 (2015). https://doi.org/10.1007/s00520-014-2489-4

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  • DOI: https://doi.org/10.1007/s00520-014-2489-4

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