Involvement of the PC team was associated with the receipt of less intensive treatments and fewer deaths in the ICU.

Adolescent and young adult (AYA) oncology patients experience many physical and psychological symptoms at the end of life (EOL); however, data on these experiences for AYA patients that have undergone hematopoietic cell transplantation (HCT) remains sparse. We sought to investigate the characteristics of AYA patients aged 15 − 25 who received allogeneic HCT and subsequently died while inpatient at our institution between the years 2008 − 2014. A standardized data extraction tool was used to collect information about patient demographics, treatment, and symptoms. We found that during this time frame, 34 AYA patients had received HCT and died while inpatient at our institution, 23 (68%) of which were due to treatment-related complications. Compared to non-HCT AYA oncology patients (n = 35), patients who received HCT (n=34) were more likely to have died in the intensive care unit (71% vs. 23%, P < .0001) and to have received mechanical ventilation (68% vs. 17%, P < .0001) or hemodialysis (53% vs. 0%, P < .0001) in the last 30 days of life. These findings demonstrate that AYA patients who receive allogeneic HCT receive intensive EOL treatment, suggesting that these patients may benefit from early integration of expert interdisciplinary services to prospectively assess and manage distressing symptoms.

Methods. Data were for Medicare patients > 65 with bone metastasis diagnosis from 12 cancer community networks affiliated with an academic center in Alabama, Mississippi, Georgia, Tennessee, and Florida. Stage IV cancer patients treated with radiation for bone metastasis from Quarter 1, 2012 to Quarter 1, 2015 were eligible and identified using and CPT/HCPCS codes. Adherence was measured by treatment duration # 14 vs >14 calendar days.