ArticleCancer2020
Goals of care discussions for patients with blood cancers: Association of person, place, and time with end-of-life care utilization.
Article in Cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Communication Interventions Targeting Both Patients and Clinicians in Oncology: A Systematic Review of Randomized Controlled Trials.Psycho-oncology · 2025Pooled it
- An inpatient Serious Illness Care Program for older patients with hematologic malignancies: a single-arm pilot study.Blood advances · 2026Trial
- Randomized controlled trial of geriatric consultation versus standard care in older adults with hematologic malignancies.Haematologica · 2022Trial
- Goals-of-care transition after an allogeneic hematopoietic stem-cell transplantation: A cross-sectional survey among hematologists on associated challenges.Bone marrow transplantation · 2026Article
- Article
- Understanding challenges and barriers to quality end-of-life care for patients with hematologic malignancies: a GIMEMA survey.Annals of hematology · 2025Article
- Prognostic discussions in patients with advanced lymphoma: Characteristics and challenges.Palliative & supportive care · 2025Article
- Portable Medical Orders and Inpatient Cost at End of Life in Acute Myeloid Leukemia and Myelodysplastic Syndromes.JCO oncology practice · 2025Article
- Challenges in the integration of palliative care for patients with hematologic malignancies: an analysis of the surprise question in a prospective cohort study.Sao Paulo medical journal = Revista paulista de medicina · 2025Article
- Challenges in hospice and end-of-life care in the transfusion-dependent patient.Hematology. American Society of Hematology. Education Program · 2024Review
- Article
- Article
- Perspectives of Patients With Relapsed and Refractory Acute Myeloid Leukemia and High-Risk Myelodysplastic Syndrome on Patient-Clinician Communication About Prognosis and the Future.Palliative medicine reports · 2024Article
- Association of appropriateness for ICU admission with resource use, organ support and long-term survival in critically ill cancer patients.Internal and emergency medicine · 2023Article
- Correlates of common concerns in older cancer survivors of leukemia and lymphoma: results from the WHI LILAC study.Journal of cancer survivorship : research and practice · 2023Article
- Differential Impact of a Multicomponent Goals-of-Care Program in Patients with Hematologic and Solid Malignancies.Cancers · 2023Article
- Elements for assistance to patients with hematological malignancies to propose care lines: a scoping review.Revista brasileira de enfermagem · 2023Article
- Team-Based Hospice Referrals: A Potential Quality Metric for Lung Cancer in the Immunotherapy Era.The American journal of hospice & palliative care · 2023Article
- Advance care planning in older patients with acute myeloid leukemia and myelodysplastic syndromes.Journal of geriatric oncology · 2023Article
- End-of-Life Care of Acute Myeloid Leukemia Compared with Aggressive lymphoma in Patients Who Are Eligible for Intensive Chemotherapy: An Observational Study in a Japanese Community Hospital.Palliative medicine reports · 2023Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundPatients with blood cancers experience high-intensity medical care near the end of life (EOL) and low rates of hospice use; attributes of goals of care (GOC) discussions may partly explain these outcomes.
methodsBy using a retrospective cohort of patients with blood cancer who received care at Dana-Farber Cancer Institute and died in 2014, the authors assessed the potential relationship between timing, location, and the involvement of hematologic oncologists in the first GOC discussion with intensity of care near the EOL and timely hospice use.
resultsAmong 383 patients, 39.2% had leukemia/myelodysplastic syndromes, 37.1% had lymphoma, and 23.7% had myeloma. Overall, 65.3% of patients had a documented GOC discussion. Of the first discussions, 33.2% occurred >30 days before death, 34.8% occurred in the outpatient setting, and 46.4% included a hematologic oncologist. In multivariable analyses, having the first discussion >30 days before death (odds ratio [OR], 0.37; 95% CI, 0.17-0.81), in the outpatient setting (OR, 0.21; 95% CI, 0.09-0.50), and having a hematologic oncologist present (OR, 0.40; 95% CI, 0.21-0.77) were associated with lower odds of intensive care unit admission ≤30 days before death. The presence of a hematologic oncologist at the first discussion (OR, 3.07; 95% CI, 1.58-5.96) also was associated with earlier hospice use (>3 days before death).
conclusionsIn this large cohort of blood cancer decedents, most initial GOC discussions occurred close to death and in the inpatient setting. When discussions were timely, outpatient, or involved hematologic oncologists, patients were less likely to experience intensive health care use near death and were more likely to enroll in hospice.
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