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Rebecca Olin, MD, MS

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Integrated Palliative and Oncology Care for Patients With AML

By: Joshua D. Madera, MS
Posted: Tuesday, February 2, 2021

For patients with acute myeloid leukemia (AML), integrated palliative and oncology care (IPC) may be an alternative therapeutic standard of care, according to the findings of a randomized clinical trial published in JAMA Oncology. Patients reported marked improvements in psychological distress, quality of life, and end-of-life care, explained Jennifer S. Temel, MD, of the Massachusetts General Hospital, Boston, and colleagues.

From 2017 to 2019, a total of 160 patients with AML undergoing intensive chemotherapy were enrolled in the study. Patients were treated with either the usual standard of care (n = 74) or IPC (n = 86). All patients treated with IPC met twice weekly with palliative care physicians. To assess quality of life, anxiety and depression, and posttraumatic stress disorder (PTSD), patients completed the Functional Assessment of Cancer Therapy–Leukemia scale, the 14-item Hospital Anxiety and Depression Scale, and the PTSD Checklist-Civilian version, respectively, at baseline and weeks 2, 4, 12, and 24.

The study findings revealed that at week 2, patients who received IPC experienced an overall improved quality of life (P = .04), decreased anxiety (P = .02), decreased depression (P = .02), and decreased PTSD symptoms (P = .01) as compared with patients who received standard care. These results were consistent at week 24 for quality of life (P = .048), anxiety (P = .04), depression (P = .04) and PTSD symptoms (P = .002). Furthermore, for patients who died during the study, those who received IPC were more willing to discuss end-of-life care preferences (75.0%) and less likely to receive chemotherapy (34.9%) as compared with patients who received standard care.

Disclosures: For full disclosures of the study authors, visit jamanetwork.com.


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