Acute Myeloblastic Leukemia in the Elderly: How Could Palliative Care Teams and Hematologists Better Work Together?

Chaumier, François; Gyan, Emmanuel; Vallet, Nicolas; Hérault, Béatrice; Mallet, Donatien

doi:10.1089/jpm.2016.0157

Cited by 2 publications

(3 citation statements)

References 4 publications

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“…There are sizeable gaps in end-of-life unmet palliative needs among patients with haematologic malignancies (Nickolich et al, 2016). The elderly patient with acute leukaemia would benefit by palliative care services, and there is a call for clinical studies in this patient population (Chaumier, Gyan, Vallet, Herault, & Mallet, 2016).…”

Section: Supportive Care and Palliationmentioning

confidence: 99%

Research agenda for life-threatening cancer

2018

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Objectives The aim of this study was to identify future research agendas that reflect the concerns and unexplored areas of interest for patients with life‐threatening cancer, their relatives and the clinical specialists during the cancer trajectory. Methods Six focus group discussions were conducted addressing two different cancer trajectories: primary malignant brain tumour and acute leukaemia. For each of the two cancer trajectories, separate FGIs were carried out with patients, relatives and clinical specialists to identify important concerns, challenges and uncertainties. The FGIs were video/audio‐recorded, transcribed and thematically analysed within and across FGI groups to construct research topics. Finally, the literature was reviewed for existing evidence concerning the identified research topic(s) to strengthen the suggested research agendas. Results New research agendas related to high‐grade glioma brain tumour and acute leukaemia with corresponding research questions were formulated within the topics of supportive care/palliation, education/information, rehabilitation, complementary and alternative therapy and organization of health care. Conclusion User involvement in identifying research agendas has the potential to improve quality of care for patients and caregivers across the cancer trajectory, while minimizing the gap in research between the healthcare user and healthcare provider.

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Section: Supportive Care and Palliationmentioning

confidence: 99%

Research agenda for life-threatening cancer

2018

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“…This has resulted in an effort from all parties involved to develop a care model for advanced planning in the same direction. [3,4] The term "good death" has been studied by many people. The first and most commonly cited report came from the Health and Medicine Division, the National Academies of Sciences, Engineering, and Medicine, USA (formerly the Institute of Medicine), in 1997, providing a definition of a good death is "one that is free from avoidable distress and suffering for patient, family, and caregivers, in general accord with the patient's and family's wishes, and reasonably consistent with clinical, cultural, and ethical standards."…”

Section: Introductionmentioning

confidence: 99%

“…This has resulted in an effort from all parties involved to develop a care model for advanced planning in the same direction. [3, 4]…”

Section: Introductionmentioning

confidence: 99%

The Association of Advanced Care Planning and Good Death in Palliative Elderly Acute Myeloid Leukemia Patients in Thailand

Tungjitviboonkun

2024

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Background: The goal of treatment for elderly AML patients is palliative care rather than curative chemotherapy. Advanced care planning (ACP) plays a crucial role in good death. However, the factors associated with ACP and good death have not been well described. Objective: This study aimed to characterize the association between advanced care planning and the outcome of good death in elderly AML patients. Method: AML patients aged ≥60, who received less intensive treatment from August 2020 to December 2021, were interviewed and prospectively followed. All clinical data and potential factors related to ACP and good death were collected. Results: Seventeen AML patients were included during the study period. The median age was 73 years (range 63-88). Twenty-five patients had passed away, with a median survival of 5.5 months. Thirteen patients had undergone ACP. Among them, twelve patients with ACP had passed away, and all had achieved good death, while six out of fifteen in the non-ACP group had achieved good death (p=0.003). Two-thirds of the ACP group initially expected to live for a year when undergoing ACP but later revised their expectations downward. In the non-ACP group, only two patients who achieved a good death were aware that AML would be the cause of death, whereas five out of six in the non-good death group were not aware of it. However, it was found that prognosis understanding alone did not correlate with successful end-of-life care. No other significant factors associated with patient outcomes were identified. Factors associated with the initiation of ACP discussions included decreased platelet count and increased blast count from baseline. Palliative performance status was not predictive when assessed too late. The median time from palliative consultation to death was 3.5 months, which appeared sufficient for patient preparation. Conclusion: The key factor associated with good death was the initiation of ACP discussions with the patient. Decreased platelet count and increased blast count from baseline could serve as warning signs.

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Acute Myeloblastic Leukemia in the Elderly: How Could Palliative Care Teams and Hematologists Better Work Together?

Cited by 2 publications

References 4 publications

Research agenda for life-threatening cancer

Research agenda for life-threatening cancer

The Association of Advanced Care Planning and Good Death in Palliative Elderly Acute Myeloid Leukemia Patients in Thailand

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