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Care of the Imminently Dying Patient with a Hematologic Malignancy or Serious Blood Disorder

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Palliative Care in Hematologic Malignancies and Serious Blood Disorders

Abstract

Patients with a hematologic malignancy or serious blood disorder represent a unique set of patients. The chronicity of these types of medical conditions cloud the ability to distinguish accurately a malignancy that may respond to other lines of therapy from those where disease-directed therapy is not curative in nature. Where the beginning of the end-of-life phase begins for patients with a hematologic malignancy is murky, and as a result, the last month of their lives is markedly different compared to patients with solid tumors. Patients with a hematologic malignancy or serious blood disorder are more likely to receive chemotherapy, visit the emergency department, and be admitted to an intensive care unit and less likely to see a palliative care specialist or enroll in hospice in the last month of their life. These make their end-of-life care different than those patients with solid tumors, and they are at a high risk for the development of distressing physical, psychosocial, and spiritual symptoms at the end of life. The benefits of well-timed delivery of specialized palliative care are associated with improved outcomes of quality-of-life measures, increased enrollment in hospice, and decreased use of non-beneficial life-prolonging interventions. This chapter aims to provide a comprehensive, evidence-based, and interdisciplinary approach to care of the imminently dying patient with a hematologic malignancy or serious blood disorder.

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Authors and Affiliations

  1. Department of Palliative, Rehabilitation, & Integrative Medicine, Division of Cancer Medicine, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA

    Kevin Madden & Eduardo Bruera

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  1. Kevin Madden
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  1. Harvard Medical School, Boston, MA, USA

    Christina K. Ullrich

  2. Oregon Health and Science University, Portland, OR, USA

    Eric J. Roeland

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Madden, K., Bruera, E. (2023). Care of the Imminently Dying Patient with a Hematologic Malignancy or Serious Blood Disorder. 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_24

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