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Integrated Palliative and Oncology Care for AML Recommended as New Standard of Care

Integrated palliative and oncology care (IPC) for patients with acute myeloid leukemia (AML) improved quality of life (QOL), psychological stress, and EOL care and should be considered a new standard of care for patients with AML, according to a recent publication in JAMA Oncology (2020;e206343. doi:10.1001/jamaoncol.2020.6343).

“Patients with AML receiving intensive chemotherapy experience substantial decline in their QOL and mood during their hospitalization for induction chemotherapy and often receive aggressive care at the end of life (EOL),” wrote Areej El-Jawahri, MD, Massachusetts General Hospital, Harvard Medical School (Boston, MA) and colleagues.

Researchers aimed to assess the effect of IPC on patient-reported and EOL outcomes in patients with AML in a multisite randomized clinical trial. The study analyzed IPC vs usual care for patients with AML undergoing intensive chemotherapy at 4 tertiary care academic hospitals in the United States.

IPC participants compared with usual care patients reported better QOL, and lower depression, anxiety, and PTSD symptoms at week 2. Intervention effects remained through week 24. IPC patients were more likely to report discussing EOL care preferences and less likely to receive chemotherapy near EOL compared with usual care.

“In this randomized clinical trial of patients with AML, IPC led to substantial improvements in QOL, psychological distress, and EOL care. Palliative care should be considered a new standard of care for patients with AML,” concluded Dr El-Jawahri and colleagues.—Lisa Kuhns