Dr Adam Olszewski on Research Still Needed on Palliative Care Services in Blood Cancers

March 3, 2020

More data is needed to get wider acceptance of the use of palliative care services for patients with blood cancers, said Adam Olszewski, MD, associate professor of medicine at The Warren Alpert Medical School of Brown University.

More data is needed to get wider acceptance of the use of palliative care services for patients with blood cancers, said Adam Olszewski, MD, associate professor of medicine at The Warren Alpert Medical School of Brown University.

Transcript

What research do you recommend next based on your findings of billed palliative care services and end of life care?

I think this research is, fortunately, already being conducted, and we're very happy and eagerly awaiting the results of the randomized trial of early palliative care in acute myeloid leukemia. There has already been research in patients undergoing bone marrow transplantation, showing significant effects and PTSD [posttraumatic stress disorder] and psychosocial outcomes.

So, I think to change the clinical practice, we really need hardcore data. And that's what clinicians will want to see. And I think as soon as the data becomes available, just as it has happened in solid tumor oncology, there'll be a much wider acceptance of the services.

And I think we also need a lot of research, which is lacking so far on describing the palliative care needs of patients with blood cancers and how they can be appropriately met. Because I think a concerns about fatigue, transfusion dependence that often affects these patients has been lacking because research has been has been focused on solid tumor patients.

We and others have shown that transfusion dependence is a barrier for early institution of hospice services even for patients who have truly terminal blood cancers. And there are some systemic barriers to it. But ASH [American Society of Hematology] is actually working towards alleviating it. But I think we also need more research about what are the actual palliative benefits of receiving red cell or platelet transfusions, and how do we define truly a positive benefits? How do we get patients’ perspective on it and integrated into our decision making?

So ,there's a lot of research in this space and fortunately, this is becoming a stronger field. Although I still would like to see more pioneer research in hematology being shown at large conferences at a high level.