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Beyond maximum grade: long-term toxicity and survivorship in haematological malignancies
Tove Wästerlid1, Bryan S Valcarcel2, Diana Presno3
1Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Hematology, Karolinska University Hospital, Stockholm, Sweden.
Abstract:
With more potent and novel treatment options, the number of survivors of haematological malignancies is increasing steadily, which in turn leads to the need for parallel improvements in survivorship monitoring and care. The present paper forms part of The Lancet Haematology Series on adverse event reporting, dedicated to improving adverse event assessment in haematological malignancies. Here, we review current survivorship care practice from a global perspective and conclude that access to long-term care plans is highly heterogeneous, with insufficient adaptation to the specific needs of haematological malignancy survivors treated curatively or non-curatively. To advance the field, we propose that clinical trials should include extended follow-up, direct patient reporting, and innovative designs that promote evaluation of survivorship care. Furthermore, we emphasise the importance of observational studies of long-term toxicities using prospective cohorts and national registers leveraged by automated data extraction and advanced statistical modelling. International collaboration and knowledge sharing will be vital to optimise survivorship care for current and future patients.
