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. 2019 Oct 28;4(6):e39.
doi: 10.1097/j.pbj.0000000000000039. eCollection 2019 Nov-Dec.

The profile of the onco-hematology patient in the palliative care: 4 years of experience

Maria Eduarda Couto  1 , Isabel Oliveira  1 , Mário Mariz  1 , José Ferraz Gonçalves  2
Affiliations

The profile of the onco-hematology patient in the palliative care: 4 years of experience

Maria Eduarda Couto et al. Porto Biomed J. .

Abstract

Objectives: Most of the palliative care (PC) patients have oncologic diseases, being hematologic tumors a small part of them. According to the literature, onco-hematologic (OH) patients should be individualized from those with solid tumors for the specialized care required along their disease course. This study aims to review the casuistry of OH patients referred to PC in a specialized oncologic hospital and help to understand better how hematologists can improve the care of these patients.

Methods: We analyzed all OH patients referred to the PC service in 1 oncologic hospital along 42 months, through consultation of their clinical files.

Results: A total of 179 patients were reviewed (52.% males, median age of 71 years): 48.6% had non-Hodgkin lymphoma, 26.3% had multiple myeloma, 10.6% had acute leukemia, 14.5% had other OH diseases; 88.2% were treated for their OH disease (96.2% with chemotherapy, 28.5% radiotherapy, and 21.5% hematopoietic stem cell transplant). The referral was heterogeneous among physicians (27.4% by 1 physician). Most patients were firstly observed as inpatients (55.3%) and 17.9% in the outpatient consult. At the end of the study, 98.9% of the patients died (88.7% in the hospital, 10.2% at home). The median time between the end of treatment and referral do PC was 46 days and between referral and death was 16 days. We also reviewed medical prescription in the last month of life and we noticed that most invasive orders were requested by hematologists (as antibiotic prescription, imaging, and biopsy studies).

Significance of results: This study demonstrated that OH patients should be referred earlier to PC and that a more intensive team work needs to be practiced between PC and hematologists. More educational programs for healthcare workers on this issue are needed in order to guarantee a more effective assistance in the appropriate time.

Keywords: care; end-of-life; haematology; onco-hematologic patients; oncology; palliative care.

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Conflict of interest statement

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this articleThe authors declare no conflicts of interest. Presentation: “A 4-year experience in Palliative Care of the Onco-hematology patient,” Abstract PB2392, 23rd European Hematology Congress. June 14 to 17, 2018. Stockholm, Sweden.

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