End-of-life characteristics and palliative care provision for elderly patients suffering from acute myeloid leukemia

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• 作者：Hon-Wai Benjamin Cheng (1) (2)
  Cho-Wing Li (1)
  Kwok-Ying Chan (1)
  Ho-Yan Au (2)
  Pan-Fong Chan (1)
  Yim-Ching Sin (1)
  Yan Szeto (1)
  Mau-Kwong Sham (1)
  
• 关键词：Elderly ; Leukemia ; AML ; Palliative ; Hematology ; End ; of ; life
• 刊名：Supportive Care in Cancer
• 出版年：2015
• 出版时间：January 2015
• 年：2015
• 卷：23
• 期：1
• 页码：111-116
• 全文大小：143 KB
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  21. Cheng HW, Li CW, Cha
• 作者单位：Hon-Wai Benjamin Cheng (1) (2)
  Cho-Wing Li (1)
  Kwok-Ying Chan (1)
  Ho-Yan Au (2)
  Pan-Fong Chan (1)
  Yim-Ching Sin (1)
  Yan Szeto (1)
  Mau-Kwong Sham (1)
  
  1. Palliative Medical Unit, Grantham Hospital, 125 Wong Chuk Hang Road, Aberdeen, Hong Kong, SAR, China
  2. Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
  
• ISSN：1433-7339

文摘

Purpose End-of-life care characteristics and palliative care (PC) utilization of elderly acute myeloid leukemia (AML) patients have rarely been reported. The aim of this study was to evaluate the cause of death, place of death and PC utilization of older adults (age 60?years or above) suffering from AML. Methods Patients were recruited retrospectively from two hematology units in Hong Kong, which consisted of one university department with Bone Marrow Transplant service, and one regional hospital with hematology specialty service. Collaboration with PC unit was established. Elderly AML patients referred to PC service were included. Medical records of all identified patients would be reviewed retrospectively by two PC physicians. Results From October 2011 to April 2013, 156 hematological cancer patients were referred for PC; 43 elderly AML patients were included into data analysis. The median time from AML diagnosis to death was 9.1?months. Up to 46.5?% patients received supportive care alone since diagnosis. More than half of elderly AML patients died in acute ward and hematology units (53.5?%), while 30.2?% died in PC settings. Overall, 51.2?% of patients spent the whole period of their final month of life in-hospital. Infection-related diagnoses contributed to 51.2?% of deaths. Median time from AML diagnosis to first PC consultation was 1.0?month. PC service includes psychosocial support (100?%), hospice in-patient care (30.2?%), homecare (60.5?%), PC outpatient clinic (14.0?%) and bereavement care (93.0?%). Conclusions Elderly AML patients carry dismal prognosis with their final phase of disease mostly hospitalized in acute care settings. Infections and bleeding could complicate course of illness and lead to rapid deterioration. PC collaboration remains important in psychosocial support and coverage of dying AML patients in non-hospice settings.