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Review
. 2022 Oct;199(1):14-30.
doi: 10.1111/bjh.18286. Epub 2022 Jun 7.

Early integration of palliative care for patients with haematological malignancies

Adir Shaulov  1   2 , Ariel Aviv  3 , Jacqueline Alcalde  4   5 , Camilla Zimmermann  4   5   6
Affiliations
Review

Early integration of palliative care for patients with haematological malignancies

Adir Shaulov et al. Br J Haematol. 2022 Oct.

Abstract

Early palliative care (EPC) significantly improves quality of life, symptoms, and satisfaction with care for patients with advanced cancer. International organizations have recognized and promoted the role of palliative care as a distinct specialty, advocating its involvement throughout the cancer trajectory. Although patients with haematologic malignancies (HMs) have a comparable symptom burden to patients with solid tumours, they face multiple barriers to EPC integration. In this review, we discuss these barriers, present updated evidence from clinical trials of EPC in HMs and propose models to support EPC integration into care for patients with HMs.

Keywords: cancer; delivery of health care; haematologic oncology; haematology; oncology; palliative care.

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Conflict of interest statement

The authors report no conflict of interests.

Figures

FIGURE 1
FIGURE 1
A conceptual model of PC delivery based on setting and provider.[Adapted with permission from Kaasa S, Loge JH, Aapro M, Albreht T, Anderson R, Bruera E, et al. Integration of oncology and palliative care: a Lancet Oncology Commission. Lancet Oncol. 2018 Nov;19 (11):e588–653]
FIGURE 2
FIGURE 2
(A) Solid malignancy trajectory.[Adapted with permission from Murray SA, Kendall M, Boyd K, Sheikh A. Illness trajectories and Palliative Care. BMJ. 2005 Apr 28;330(7498):1007–11. (B) Aggressive HM trajectory – “The rollercoaster”: acute leukaemia, aggressive lymphoma, stem cell transplantation, acute graft‐vs.‐host disease [developed by the authors]. (C) Indolent HM trajectory – “The war of attrition”: indolent lymphoma, multiple myeloma, chronic lymphocytic lymphoma [developed by the authors]. (D) Bone marrow failure “the transfusion tether”: myelodysplasia, myelofibrosis [developed by the authors]
FIGURE 3
FIGURE 3
Comparison of the percentage of publications including the keywords ‘palliative’, ‘palliate’ or ‘palliation’ in the article title, in five leading haematology journals versus oncology journals over the years 2011–2021.The leading journals in heamatology and medical oncology were selected by the yearly impact factor designated by Journal Citation Reports. Haematology journals without an oncology focus were not included (i.e., Circulation, Circulation Research). Within each journal, a search for the terms ‘palliate’ ‘palliation’ or ‘palliative’ within the article title, including meeting abstracts, was conducted using the Web of Science database. Oncology journals included were: CA: A Cancer Journal for Clinicians, Nature Reviews Clinical Oncology, Nature Reviews Cancer, Journal of Clinical Oncology and Lancet Oncology. Haematology journals included were: Blood, Lancet Haematology (from 2014), Journal of Haematology and Oncology, Blood Cancer Journal and Leukaemia. Mann–Whitney–Wilcoxon test was used to compare the two groups (p < 0.0001)
See this image and copyright information in PMC

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