Symptom burden and supportive care in patients with acute leukemia

Abstract

We examined the symptoms and referral rates to specialized palliative care and psychosocial oncology services of patients with acute leukemia. The Memorial Symptom Assessment Scale (MSAS) was completed by 249 adult patients with acute leukemia. Patients reported a median of 9 physical and 2 psychological symptoms, and those with intense lack of energy, difficulty sleeping and pain were more likely to report intense worrying/sadness (P < 0.001). No patients with moderate-severe pain were referred for specialized symptom control and only 13% of those with severe worrying/sadness were referred to psychiatry/psychology within one month of the *

Perceptions of palliative care among hematologic malignancy specialists: A mixed-methods study.

“…Patients with hematologic malignancies have significant palliative care needs, including high symptom burden [15][16][17] ; however, they remain less likely than patients with solid tumors to receive specialist palliative care services and more likely to receive aggressive health care at the end of life. 18 Specifically, patients with blood cancers are less frequent users of hospice services, 19 less likely to be seen by consultative palliative care services in the hospital, 20 more likely to die in a hospital or intensive care unit, [21][22][23] and more likely to receive chemotherapy in the last few weeks of life.…”

Keep your mind off negative things: coping with long-term effects of acute myeloid leukemia (AML)

“…Additionally, our analysis revealed that participants were affected with an overwhelming sense of loss, fear, and uncertainty in the early phase of IC [7]. Likewise, two recent cross-sectional studies on newly diagnosed AML patients receiving IC and one longitudinal study of AML patients undergoing prolonged chemotherapy documented a high prevalence of traumatic stress symptoms, intense worrying and sadness, uncertainty about durable remission, and fear of cancer recurrence as serious threat to psychological well-being [4,5,8]. Correspondingly, several qualitative studies investigating patients' perspectives on the initial phase of leukemia diagnosis, IC, and bone marrow transplantation (BMT) noted a sense of shock, emotional numbness, threat, insecurity, uncertainty, and fear regarding diagnosis, invasive procedures, cancer recurrence, and transplant rejection [9][10][11][12].…”

“…Receiving a diagnosis of AML and undergoing chemotherapy are traumatic experiences burdened with enormous physical and psychological distress [4,5,7]. Effective coping strategies are required to adjust to life with AML [24,25].…”

“…Although various treatments exist, intensive chemotherapy (IC) is the treatment of choice to achieve disease remission and prolong survival [1,3]. However, IC is burdened with severe toxicities and distress [4][5][6]. In our recent study in patients with AML, we showed that fatigue, weakness, dizziness, and chemobrain were the most bothersome physical symptoms just after completing IC [7].…”

Optimizing End-of-Life Care for Patients With Hematological Malignancy: Rethinking the Role of Palliative Care Collaboration

“…As demonstrated in a previous study, a high frequency of anxiety and depression was detected by the Hospital Anxiety and Depression Scale in about one-third of acute myeloid leukemia patients at diagnosis. 4 The rapid onset and fluctuating course of hematological malignancies, with frequent life-threatening complications, suggest that anxiety symptoms including posttraumatic stress disorder may be a common accompaniment. 5 Furthermore, terminal hematological cancer patients may suffer from other problems identical to those of the general cancer population, including loss of autonomy and disability.…”