Symptom burden and palliative care in patients with hematologic malignancies: a single-center experience

BACKGROUND: Patients with hematological malignancies are a heterogeneous group with special palliative care needs. They are known to have many symptoms and frequent emergency room visits and hospitalizations in the end-of-life phase. However, there are limited data about the symptom burden and health care service utilization in different diagnostic groups of hematological malignancies. OBJECTIVES: The purpose of this study was to define the symptom burden and characteristics of the palliative care phase in patients with hematological malignancies in different diagnostic groups. METHODS: This retrospective study comprised 195 patients with hematological malignancies who were treated in the Kuopio University Hospital palliative care unit and died between 1.1.2015 and 31.12.2023. Patients were divided into four patient groups: myeloma, lymphoma, leukemia and myelodysplastic syndrome or myeloproliferative neoplasm (MDS/MPN). RESULTS: All patient groups had a considerable symptom burden, with many emergency room visits and hospital admissions near death. Furthermore, palliative care involvement occurred late. Fatigue, pain, and dyspnea were the most common symptoms in myeloma and lymphoma patients; fatigue, pain and loss of appetite in leukemia patients and fatigue, dyspnea and depression or anxiety in MDS/MPN patients in palliative care. CONCLUSION: Patients with hematological malignancies have a significant symptom burden and remarkable palliative care needs at the end of life. More research and awareness of the benefits of palliative care are needed.