Subjects:
Evidence-Based Minireview
Learning Objectives
Review recent studies that have characterized the benefits of integrated palliative care in hematologic malignancies
Explain what features of integrated palliative care lead to improved outcomes in hematologic malignancies
A 62-year-old man is diagnosed with acute myeloid leukemia (AML). Molecular genetic testing reveals an NPM1 mutation without FLT3 mutation. He undergoes induction chemotherapy with cytarabine/daunorubicin with a complete response, followed by consolidation with high-dose cytarabine, but has a persisting NPM1 mutation by quantitative polymerase chain reaction testing. Ultimately, a matched unrelated donor hematopoietic stem cell transplant (HSCT) is offered with curative intent. He is admitted to the hospital for conditioning chemotherapy with busulfan/cyclophosphamide. Palliative care (PC) consultation is offered to the patient. Do patients undergoing HSCT benefit from PC during their initial transplant hospitalization?
The integration of PC in hematologic malignancies has lagged behind solid oncology for many...
References
1.
El-Jawahri
A
, Nelson
AM
, Gray
TF
, Lee
SJ
, LeBlanc
TW
. Palliative and end-of-life care for patients with hematologic malignancies
. J Clin Oncol
. 2020
;38
(9
):944
-953
.2.
Kayastha
N
, LeBlanc
TW
. When to integrate palliative care in the trajectory of cancer care
. Curr Treat Options Oncol
. 2020
;21
(5
):41
.3.
Kayastha
N
, LeBlanc
TW
. Palliative care for patients with hematologic malignancies: are we meeting patients' needs early enough?
Expert Rev Hematol
. 2022
;15
(9
):813
-820
.4.
Egan
PC
, LeBlanc
TW
, Olszewski
AJ
. End-of-life care quality outcomes among Medicare beneficiaries with hematologic malignancies
. Blood Adv
. 2020
;4
(15
):3606
-3614
.5.
Thienprayoon
R
, LeBlanc
T
. Early integration of palliative care into the care of patients with cancer
. Hematology Am Soc Hematol Educ Program
. 2015
;2015
(1
):479
-483
.6.
Sanders
JJ
, Temin
S
, Ghoshal
A
, et al. Palliative care for patients with cancer: ASCO guideline update
. JCO Oncol Pract
. 15
May
2024
:OP2400225
.7.
Zimmermann
C
, Yuen
D
, Mischitelle
A
, et al. Symptom burden and supportive care in patients with acute leukemia
. Leuk Res
. 2013
;37
(7
):731
-736
.8.
El-Jawahri
A
, LeBlanc
TW
, Kavanaugh
A
, et al. Effectiveness of integrated palliative and oncology care for patients with acute myeloid leukemia: a randomized clinical trial
. JAMA Oncol
. 2021
;7
(2
):238
-245
.9.
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
(6
):951
-959
.10.
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
(20
):2094
-2103
.11.
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
(32
):3714
-3721
.12.
El-Jawahri
A
, LeBlanc
TW
, Kavanaugh
A
, et al. Multi-site randomized trial of inpatient palliative care for hospitalized patients undergoing hematopoietic stem cell transplantation
. Blood
. 2023
;142
(suppl 1
):913
.13.
Irwin
KE
, Greer
JA
, Khatib
J
, Temel
JS
, Pirl
WF
. Early palliative care and metastatic non-small cell lung cancer: potential mechanisms of prolonged survival
. Chron Respir Dis
. 2013
;10
(1
):35
-47
.14.
Jacobsen
J
, Jackson
V
, Greer
J
, Temel
J
. What's in the Syringe? Principles of Early Integrated Palliative Care
. Oxford University Press
; 2021
.15.
Amonoo
HL
, Daskalakis
E
, Deary
EC
, et al. Relationship between longitudinal coping strategies and outcomes in patients with acute myeloid leukemia
. J Natl Compr Canc Netw
. 2022
;20
(10
):1116
-1123
.16.
Greer
JA
, Applebaum
AJ
, Jacobsen
JC
, Temel
JS
, Jackson
VA
. Understanding and addressing the role of coping in palliative care for patients with advanced cancer
. J Clin Oncol
. 2020
;38
(9
):915
-925
.17.
Nelson
AM
, Amonoo
HL
, Kavanaugh
AR
, et al. Palliative care and coping in patients with acute myeloid leukemia: mediation analysis of data from a randomized clinical trial
. Cancer
. 2021
;127
(24
):4702
-4710
.18.
Epstein
AS
, Goldberg
GR
, Meier
DE
. Palliative care and hematologic oncology: the promise of collaboration
. Blood Rev
. 2012
;26
(6
):233
-239
.19.
Kamal
AH
, Bausewein
C
, Casarett
DJ
, Currow
DC
, Dudgeon
DJ
, Higginson
IJ
. Standards, guidelines, and quality measures for successful specialty palliative care integration into oncology: current approaches and future directions
. J Clin Oncol
. 2020
;38
(9
):987
-994
.20.
Zhuang
Q
, Zhang
AY
, Cong
RSTY
, et al. Towards proactive palliative care in oncology: developing an explainable EHR-based machine learning model for mortality risk prediction
. BMC Palliat Care
. 2024
;23
(1
):124
.21.
Manz
CR
, Zhang
Y
, Chen
K
, et al. Long-term effect of machine learning–triggered behavioral nudges on serious illness conversations and end-of-life outcomes among patients with cancer: a randomized clinical trial
. JAMA Oncol
. 2023
;9
(3
):414
-418
.22.
Masukawa
K
, Aoyama
M
, Yokota
S
, et al. Machine learning models to detect social distress, spiritual pain, and severe physical psychological symptoms in terminally ill patients with cancer from unstructured text data in electronic medical records
. Palliat Med
. 2022
;36
(8
):1207
-1216
.23.
Sedhom
R
, Shulman
LN
, Parikh
RB
. Precision palliative care as a pragmatic solution for a care delivery problem
. J Clin Oncol
. 2023
;41
(16
):2888
-2892
.24.
Hui
D
, De La Rosa
A
, Chen
J
, et al. State of palliative care services at US cancer centers: an updated national survey
. Cancer
. 2020
;126
(9
):2013
-2023
.Copyright © 2024 by The American Society of Hematology
2024
Copyright © 2024 by The American Society of Hematology
2024
You do not currently have access to this content.
