Dr El-Jawahri on the Benefits of Earlier Palliative Care in Hematologic Malignancies

Areej El-Jawahri, MD, associate director, Cancer Outcomes Research and Education Program, director, Bone Marrow Transplant Survivorship Program, associate professor, medicine, Massachusetts General Hospital, discusses the potential benefits of incorporating palliative care approaches earlier in the treatment course for patients with hematologic malignancies.

El-Jawahri and colleagues conducted a multi-site, randomized trial (NCT03310918) comparing outcomes with a collaborative palliative and oncology care model vs usual care in patients diagnosed with acute myeloid leukemia (AML) and high-risk myelodysplastic syndrome (MDS) receiving nonintensive therapy at 2 tertiary care academic hospitals (n = 115).

Results presented at the 2024 ASCO Annual Meeting highlighted critical differences in end-of-life care delivery and quality of life (QOL) between the two care models. Patients who received the palliative care interventions exhibited markedly improved end-of-life planning and QOL outcomes vs the standard care group. Furthermore, patients experienced a trend toward reduced anxiety symptoms with palliative care vs usual care.

Growing evidence has demonstrated the benefits of integrating palliative care into oncology beyond end-of-life support, El-Jawahri begins. In addition to the data presented at the 2024 ASCO Annual Meeting, 4 other randomized clinical trials have shown how early palliative care integration can significantly affect a range of patient- and caregiver-reported outcomes, particularly in patients receiving curative treatments, she reports.

Palliative care is often misperceived as synonymous with end-of-life care, but it plays a crucial role much earlier in the treatment journey, El-Jawahri continues. These studies highlight that the integration of palliative care can benefit patients undergoing intensive therapies, such as chemotherapy for leukemia or stem cell transplants, by improving their overall QOL and addressing symptoms like fatigue and pain, she states. Beyond immediate symptom relief, palliative care has been shown to improve long-term survivorship, El-Jawahri adds. Patients receiving palliative care also report lower rates of depression and post-traumatic stress, she notes.

Overall, this study is part of a larger body of research that underscores the broader applications of palliative care, El-Jawahri emphasizes. The evidence suggests that integrating palliative care earlier in the treatment process, particularly with the involvement of specialized clinicians, could significantly enhance the care of patients with hematologic malignancies, she concludes.