According to findings from a retrospective study presented at the 63rd ASH Annual Meeting & Exposition, hospice services were utilized by more than half of deceased patients with diffuse large B-cell lymphoma (DLBCL) within the Veterans Health Administration (VHA). Additionally, age or race were not determined to be barriers to access.

“Early recognition of high-risk patients may correlate with earlier enrollment to hospice and increased lengths of stay in hospice for patients with aggressive hematological malignancies,” stated authors of the study.

Researchers conducted a retrospective chart review of 3274 patients who had an ICD code for lymphoma and were treated by the VHA between January 1, 2011 and December 31, 2017. A total of 1699 veterans had confirmed DLBCL diagnoses, of which researchers analyzed 830 deceased patients.

Researchers found approximately three-fourths had an ECOG performance status of 0 to 2 at the time of diagnosis and more than 50% had an IPI score of 4 or 5 and were diagnosed at stages 3 and 4.

“Within the study, 63%, 60% and 52% of patients were introduced to palliative care, had hospice discussions, and enrolled in hospice respectively,” stated authors of the study. “The median overall survival (OS) from date of diagnosis to death was 461 days, and the median time from hospice enrollment to death for those with a known Hospice enrollment date was 12 days.”

Results from the study also showed, “Patients with complete response to first-line treatment had longer median OS in comparison to the four other groups: patients who received no first line treatments, who began a first line treatment which was interrupted by death, who were relapsed/refractory (R/R) after first line treatment and those with an unknown treatment response.”

Patients with an unknown treatment response, R/R patients, or patients who did not receive any first-line treatments were more likely to have a palliative care consult, discuss hospice with a provider and enroll in hospice, according to researchers.

Results demonstrated no significant differences in median time within hospice between the successful treatment group and the four other groups.

“Future educational interventions are needed to improve Hospice utilization for end of life care in patients with hematological malignancies,” concluded authors.

Reference:
Lucero KT, Williams MH, Williams RA, et al. A retrospective study of hospice enrollment in patients with diffuse large b cell lymphoma within the Veterans Health Administration. Poster presented at: 63rd ASH Annual Meeting & Exposition; December 11-14, 2021; Atlanta, GA.