[Home hospice care for the blood cancer patients]

In order to clarify the clinical characteristics along with the practical care that we provided, 21 terminally ill blood cancer patients who died at home from July 1 in 2003 to May 31 in 2010 were analyzed and compared with 733 non-blood cancer patients. The patients'characteristics such as age, gender and the home death frequency did not show a significant difference. The home care period for blood cancer patients showed that it tended to be a short duration, but not a statistically-significant difference. For the cases of longer period of more than 15 days at home, focus lists at each phase based on total suffering classification did not show significant differences between the two groups. The frequency of strong opioid usage was significantly lower in the blood cancer patients, whereas a strong opioid was used for pain relief in multiple myeloma cases. As a preliminary report, firstly, although frequency of hematological malignancy in home hospice care is low, the care was not difficult by comparison with that of the non-hematological malignancies. Secondly, the main issue of symptom control was a pain relief, and fentanyl patch was the first-choice strong opioid without the need of opioid rotation because relief of dyspnea was few. Thirdly, in the multiple myeloma, the pain relief was the most important issue that was compared with in other blood cancer patients. And fourthly, although the hemorrhage was a big focus in case of leukemia, it didn't force to cease the home care.