Abstract
Palliative care is an essential part of high-quality care for patients living with serious illness. It improves the quality of life, mood, and symptom burden of patients without adversely affecting their survival. Palliative care also results in improved quality of life for patients’ caregivers. Unfortunately, until recently, patients with hematologic malignancies were substantially underrepresented in palliative care research. This underrepresentation has been mirrored in clinical care as blood cancer patients have the lowest rates of palliative care engagement in oncology while having high intensive healthcare utilization rates near the end of life. Recognition of this gap spurred a significant growth of palliative care research focused on hematologic malignancies over the past decade. Research has now led to a clear understanding of the unmet palliative care needs and barriers to optimal care for this patient population. While there has been advancement of palliative care research for patients with hematologic malignancies, there is a striking paucity of research for individuals with other serious blood disorders that are not malignant. In this chapter, we discuss the evolution of palliative care research in hematologic oncology and review the major themes that have emerged. We also discuss future directions and highlight the need for intervention studies to optimize palliative care for patients with hematologic malignancies.
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References
Zimmermann C, Swami N, Krzyzanowska M, et al. Early palliative care for patients with advanced cancer: a cluster-randomised controlled trial. Lancet. 2014;383:1721–30.
Temel JS, Greer JA, Muzikansky A, et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med. 2010;363:733–42.
Bakitas M, Lyons KD, Hegel MT, et al. Effects of a palliative care intervention on clinical outcomes in patients with advanced cancer: the project ENABLE II randomized controlled trial. JAMA. 2009;302:741–9.
Bakitas MA, Tosteson TD, Li Z, et al. Early versus delayed initiation of concurrent palliative oncology care: patient outcomes in the ENABLE III randomized controlled trial. J Clin Oncol. 2015;33:1438–45.
Earle CC, Landrum MB, Souza JM, Neville BA, Weeks JC, Ayanian JZ. Aggressiveness of cancer care near the end of life: is it a quality-of-care issue? J Clin Oncol. 2008;26:3860–6.
Hui D, Didwaniya N, Vidal M, et al. Quality of end-of-life care in patients with hematologic malignancies: a retrospective cohort study. Cancer. 2014;120:1572–8.
Epstein AS, Goldberg GR, Meier DE. Palliative care and hematologic oncology: the promise of collaboration. Blood Rev. 2012;26:233–9.
Johnston EE, Adesina OO, Alvarez E, et al. Acute care utilization at end of life in sickle cell disease: highlighting the need for a palliative approach. J Palliat Med. 2020;23:24–32.
El-Jawahri AR, Abel GA, Steensma DP, et al. Health care utilization and end-of-life care for older patients with acute myeloid leukemia. Cancer. 2015;121:2840–8.
LeBlanc TW, Abernethy AP, Casarett DJ. What is different about patients with hematologic malignancies? A retrospective cohort study of cancer patients referred to a hospice research network. J Pain Symptom Manag. 2015;49:505–12.
O'Connor NR, Hu R, Harris PS, Ache K, Casarett DJ. Hospice admissions for cancer in the final days of life: independent predictors and implications for quality measures. J Clin Oncol. 2014;32:3184–9.
Fletcher SA, Cronin AM, Zeidan AM, et al. Intensity of end-of-life care for patients with myelodysplastic syndromes: findings from a large national database. Cancer. 2016;122:1209–15.
Wang R, Zeidan AM, Halene S, et al. Health care use by older adults with acute myeloid leukemia at the end of life. J Clin Oncol. 2017;35:3417–24.
Wang WS, Ma JD, Nelson SH, et al. Transfusion practices at end of life for hematopoietic stem cell transplant patients. Support Care Cancer. 2018;26:1927–31.
Odejide OO, Uno H, Murillo A, Tulsky JA, Abel GA. Goals of care discussions for patients with blood cancers: association of person, place, and time with end-of-life care utilization. Cancer. 2020;126:515–22.
LeBlanc TW, Egan PC, Olszewski AJ. Transfusion dependence, use of hospice services, and quality of end-of-life care in leukemia. Blood. 2018;132:717–26.
Odejide OO, Cronin AM, Earle CC, LaCasce AS. Abel GA, vol. 108. Hospice Use Among Patients With Lymphoma: Impact of Disease Aggressiveness and Curability. J Natl Cancer Inst; 2016. p. 108.
Odejide OO, Li L, Cronin AM, et al. Meaningful changes in end-of-life care among patients with myeloma. Haematologica. 2018;103:1380–9.
Hui D, Kim SH, Kwon JH, et al. Access to palliative care among patients treated at a comprehensive cancer center. Oncologist. 2012;17:1574–80.
Beaussant Y, Daguindau E, Chauchet A, et al. Hospital end-of-life care in haematological malignancies. BMJ Support Palliat Care. 2018;8:314–24.
Johnston EE, Alvarez E, Saynina O, Sanders L, Bhatia S, Chamberlain LJ. Disparities in the intensity of end-of-life Care for Children with Cancer. Pediatrics. 2017;140(4):e20170671.
Ullrich CK, Lehmann L, London WB, et al. End-of-life care patterns associated with pediatric palliative care among children who underwent hematopoietic stem cell transplant. Biol Blood Marrow Transplant. 2016;22:1049–55.
Odejide OO, Salas Coronado DY, Watts CD, Wright AA, Abel GA. End-of-life care for blood cancers: a series of focus groups with hematologic oncologists. J Oncol Pract. 2014;10:e396–403.
LeBlanc TW, O'Donnell JD, Crowley-Matoka M, et al. Perceptions of palliative care among hematologic malignancy specialists: a mixed-methods study. J Oncol Pract. 2015;11:e230–8.
Henckel C, Revette A, Huntington SF, Tulsky JA, Abel GA, Odejide OO. Perspectives regarding hospice services and transfusion access: focus groups with blood cancer patients and bereaved caregivers. J Pain Symptom Manag. 2020;59:1195.
McCaughan D, Roman E, Smith AG, et al. Perspectives of bereaved relatives of patients with haematological malignancies concerning preferred place of care and death: a qualitative study. Palliat Med. 2019;33:518–30.
McCaughan D, Roman E, Smith AG, et al. Determinants of hospital death in haematological cancers: findings from a qualitative study. BMJ Support Palliat Care. 2018;8:78–86.
McCaughan D, Roman E, Smith AG, et al. Palliative care specialists' perceptions concerning referral of haematology patients to their services: findings from a qualitative study. BMC Palliat Care. 2018;17:33.
Odejide OO, Cronin AM, Condron N, Earle CC, Wolfe J, Abel GA. Timeliness of end-of-life discussions for blood cancers: a National Survey of hematologic oncologists. JAMA Intern Med. 2016;176:263–5.
Odejide OO, Cronin AM, Condron NB, et al. Barriers to quality end-of-life Care for Patients with Blood Cancers. J Clin Oncol. 2016;34:3126–32.
Odejide OO, Cronin AM, Earle CC, Tulsky JA, Abel GA. Why are patients with blood cancers more likely to die without hospice? Cancer. 2017;123:3377–84.
Hui D, Bansal S, Park M, et al. Differences in attitudes and beliefs toward end-of-life care between hematologic and solid tumor oncology specialists. Ann Oncol. 2015;26:1440–6.
Hui D, Cerana MA, Park M, Hess K, Bruera E. Impact of Oncologists' attitudes toward end-of-life care on patients’ access to palliative care. Oncologist. 2016;21:1149–55.
Hui D, Park M, Liu D, Reddy A, Dalal S, Bruera E. Attitudes and beliefs toward supportive and palliative care referral among hematologic and solid tumor oncology specialists. Oncologist. 2015;20:1326–32.
El-Jawahri A, LeBlanc TW, Burns LJ, et al. What do transplant physicians think about palliative care? A national survey study. Cancer. 2018;124:4556–66.
Martins Y, Lederman RI, Lowenstein CL, et al. Increasing response rates from physicians in oncology research: a structured literature review and data from a recent physician survey. Br J Cancer. 2012;106:1021–6.
El-Jawahri A, LeBlanc T, VanDusen H, et al. Effect of inpatient palliative care on quality of life 2 Weeks after hematopoietic stem cell transplantation: a randomized clinical trial. JAMA. 2016;316:2094–103.
El-Jawahri A, Traeger L, Greer JA, et al. Effect of inpatient palliative care during hematopoietic stem-cell transplant on psychological distress 6 months after transplant: results of a randomized clinical trial. J Clin Oncol. 2017;35:3714–21.
LeBlanc TW, Lodato JE, Currow DC, Abernethy AP. Overcoming recruitment challenges in palliative care clinical trials. J Oncol Pract. 2013;9:277–82.
Manitta V, Zordan R, Cole-Sinclair M, Nandurkar H, Philip J. The symptom burden of patients with hematological malignancy: a cross-sectional observational study. J Pain Symptom Manag. 2011;42:432–42.
Hochman MJ, Yu Y, Wolf SP, Samsa GP, Kamal AH, LeBlanc TW. Comparing the palliative care needs of patients with hematologic and solid malignancies. J Pain Symptom Manag. 2018;55:82–88.e81.
LeBlanc TW, Smith JM, Currow DC. Symptom burden of haematological malignancies as death approaches in a community palliative care service: a retrospective cohort study of a consecutive case series. Lancet Haematol. 2015;2:e334–8.
El-Jawahri AR, Traeger LN, Kuzmuk K, et al. Quality of life and mood of patients and family caregivers during hospitalization for hematopoietic stem cell transplantation. Cancer. 2015;121:951–9.
Fadul NA, El Osta B, Dalal S, Poulter VA, Bruera E. Comparison of symptom burden among patients referred to palliative care with hematologic malignancies versus those with solid tumors. J Palliat Med. 2008;11:422–7.
El-Jawahri AR, Vandusen HB, Traeger LN, et al. Quality of life and mood predict posttraumatic stress disorder after hematopoietic stem cell transplantation. Cancer. 2016;122:806–12.
Dirou S, Chambellan A, Chevallier P, et al. Deconditioning, fatigue and impaired quality of life in long-term survivors after allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant. 2018;53:281–90.
Sexauer A, Cheng MJ, Knight L, Riley AW, King L, Smith TJ. Patterns of hospice use in patients dying from hematologic malignancies. J Palliat Med. 2014;17:195–9.
Philip T, Guglielmi C, Hagenbeek A, et al. Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgkin's lymphoma. N Engl J Med. 1995;333:1540–5.
Neelapu SS, Locke FL, Bartlett NL, et al. Axicabtagene Ciloleucel CAR T-cell therapy in refractory large B-cell lymphoma. N Engl J Med. 2017;377:2531–44.
El-Jawahri A, Nelson-Lowe M, VanDusen H, et al. Patient-clinician discordance in perceptions of treatment risks and benefits in older patients with acute myeloid leukemia. Oncologist. 2019;24:247–54.
Loh KP, Xu H, Back A, et al. Patient-hematologist discordance in perceived chance of cure in hematologic malignancies: a multicenter study. Cancer. 2020;126:1306–14.
El-Jawahri A, Traeger L, Kuzmuk K, et al. Prognostic understanding, quality of life and mood in patients undergoing hematopoietic stem cell transplantation. Bone Marrow Transplant. 2015;50:1119–24.
Howell DA, Wang HI, Roman E, et al. Preferred and actual place of death in haematological malignancy. BMJ Support Palliat Care. 2017;7:150–7.
Buss MK, Lessen DS, Sullivan AM, Von Roenn J, Arnold RM, Block SD. Hematology/oncology fellows' training in palliative care: results of a national survey. Cancer. 2011;117:4304–11.
Thomas RA, Curley B, Wen S, Zhang J, Abraham J, Moss AH. Palliative care training during fellowship: a National Survey of U.S. hematology and oncology fellows. J Palliat Med. 2015;18:747–51.
Dumanovsky T, Augustin R, Rogers M, Lettang K, Meier DE, Morrison RS. The growth of palliative Care in U.S. hospitals: a status report. J Palliat Med. 2016;19:8–15.
Loggers ET, LeBlanc TW, El-Jawahri A, et al. Pretransplantation supportive and palliative care consultation for high-risk hematopoietic cell transplantation patients. Biol Blood Marrow Transplant. 2016;22:1299–305.
Selvaggi KJ, Vick JB, Jessell SA, Lister J, Abrahm JL, Bernacki R. Bridging the gap: a palliative care consultation service in a hematological malignancy-bone marrow transplant unit. J Community Support Oncol. 2014;12:50–5.
Porta-Sales J, Guerrero-Torrelles M, Moreno-Alonso D, et al. Is early palliative care feasible in patients with multiple myeloma? J Pain Symptom Manag. 2017;54:692–700.
Roeland E, Mitchell W, Elia G, et al. Symptom control in stem cell transplantation: a multidisciplinary palliative care team approach. Part 1: physical symptoms. J Support Oncol. 2010;8:100–16.
Roeland E, Mitchell W, Elia G, et al. Symptom control in stem cell transplantation: a multidisciplinary palliative care team approach. Part 2: psychosocial concerns. J Support Oncol. 2010;8:179–83.
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Odejide, O.O. (2023). Advancing the Field through Research. In: Ullrich, C.K., Roeland, E.J. (eds) Palliative Care in Hematologic Malignancies and Serious Blood Disorders. Springer, Cham. https://doi.org/10.1007/978-3-031-38058-7_19
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DOI: https://doi.org/10.1007/978-3-031-38058-7_19
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