End-of-life care for older AML patients relapsing after allogeneic stem cell transplant at a dedicated cancer center.
Bone Marrow Transplant
; 54(5): 700-706, 2019 05.
Article
em En
| MEDLINE
| ID: mdl-30135464
ABSTRACT
Older patients with acute myelogenous leukemia (AML) are at increased risk for mortality and morbidity. While allogeneic stem cell transplantation may provide cure in some patients, many still relapse after transplant and are then left with limited therapeutic options and poor survival. Moreover, the quality of the end-of-life care for these patients has not been previously reported. We describe here the end-of-life experience of a cohort of 72 older patients with AML who relapsed after first allogeneic stem cell transplant at our dedicated cancer center. Despite a median overall survival of only 4 months, we find a high level of primary palliative care delivered by transplant/leukemia physicians through goals of care discussions and/or advanced care planning and provide evidence for high-quality end-of-life care outcomes, often with concurrent disease-directed therapy. Our results compare favorably with end-of-life care outcomes reported for older AML patients, including those who did not undergo transplant. Given the poor prognosis and unique underlying vulnerabilities in this high-risk patient population, incorporating timely advanced care planning and palliative care delivery while exploring available salvage options may further improve end-of-life care outcomes.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Assistência Terminal
/
Institutos de Câncer
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Leucemia Mieloide Aguda
/
Transplante de Células-Tronco Hematopoéticas
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
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Male
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Middle aged
Idioma:
En
Revista:
Bone Marrow Transplant
Assunto da revista:
TRANSPLANTE
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Estados Unidos