Acute Myeloid Leukemia: Challenges in Delivering End-of-Life Care
Vani Koets1, Marcos Montagnini2
1Hospice and Palliative Medicine, Spectrum Health Medical Group, Grand Rapids, MI, USA.
The American Journal of Hospice & Palliative Care
|August 29, 2022
Summary
Patients with Acute Myeloid Leukemia (AML) face significant end-of-life (EOL) challenges, including symptom burden and underutilized palliative care. This case highlights the complexities of balancing patient autonomy with blood transfusions near EOL.
Area of Science:
- Hematology
- Palliative Care
- Oncology
Background:
- Acute Myeloid Leukemia (AML) presents a complex trajectory with high symptom burden and frequent end-of-life (EOL) hospitalizations.
- Palliative and hospice care remain underutilized in AML patients despite their poor prognosis.
Observation:
- Clinicians face challenges managing end-stage AML, particularly concerning blood product administration near EOL.
- A case illustrates patient and caregiver distress stemming from transfusion desires in end-stage AML.
Findings:
- Frequent chemotherapy use near EOL is common in AML.
- Blood product administration near EOL presents ethical and clinical dilemmas.
Implications:
- Optimal EOL care for AML requires balancing patient autonomy with potentially inappropriate interventions like transfusions.
- Effective communication and interdisciplinary collaboration are crucial for managing complex EOL care in AML patients.
Keywords:
acute myeloid leukemiablood cancerscase reportend-of-life carehematological maliganciespalliative careMore Related Videos
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