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Characteristics of palliative home care for patients with hematological tumors compared to those of patients with solid tumors

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Abstract

Home care medicine is a platform for providing supportive care for end-stage cancers. However, for undefined reasons, patients with hematological tumors (HTs) often fail to receive opportunities for home care. We, therefore, sought to delineate the clinical differences between solid tumors (STs) and HTs and to determine whether home care is effective for patients with HTs, as well as those with STs. We retrospectively analyzed the treatments, prognosis, and places of death of patients with STs (n = 99) and HTs (n = 20) who received palliative home care in our clinic and subsequently died between May 2016 and May 2018. Patients with HTs commonly required intravenous antibiotics, platelet transfusion, and red blood cell transfusion, while patients with STs tended to more frequently require the use of opioids. Importantly, there were no significant differences between the cohorts with respect to survival time and frequency of emergent visits to patients after their referral to us. Furthermore, most patients in both groups died at home. More than 50% of patients were not admitted to hospitals during our follow-up. Collectively, while therapeutic approaches sometimes differ, this study provides clinical evidence that palliative home care can be feasible even for patients with HTs.

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Abbreviations

HTs:

Hematological tumors

STs:

Solid tumors

MDS:

Myelodysplastic syndromes

QoL:

Quality of life

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Acknowledgements

We thank Sachie Yamaguchi, Akiko Ryuo, Takahiro Suzuki, Jun Suzuki, Nobumasa Omura, Maki Omura, and Hironobu Hashimoto for their unselfish dedication to patient care.

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Author notes

  1. Takashi Ishida and Kota Ohashi contributed equally to this work.

Authors and Affiliations

  1. Department of Transfusion and Cell Transplantation, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan

    Takashi Ishida & Koji Miyazaki

  2. TOTUS Home Care Clinic, 4-22-7-102 Iwato Minami, Komae, Tokyo, 201-0005, Japan

    Takashi Ishida, Kota Ohashi, Chikako Okina & Shiho Ohashi

  3. Department of Hematology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan

    Takashi Ishida, Sosei Okina & Takahiro Suzuki

  4. Department of Nephrology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan

    Chikako Okina

Authors
  1. Takashi Ishida
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  2. Kota Ohashi
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  3. Chikako Okina
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  4. Shiho Ohashi
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  5. Sosei Okina
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  6. Koji Miyazaki
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  7. Takahiro Suzuki
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Contributions

Study conception and design, data acquisition, and data analysis and interpretation: TI, KO, CO, SO, SO, KM, and TS. Article drafting or critical revision for important intellectual content: TI, KO, KM, and TS. Final approval of the submitted version: TI, KO, CO, SO, SO, KM, and TS.

Corresponding author

Correspondence to Takahiro Suzuki.

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The authors declare that they have no conflict of interest in relation to this study.

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Ishida, T., Ohashi, K., Okina, C. et al. Characteristics of palliative home care for patients with hematological tumors compared to those of patients with solid tumors. Int J Hematol 110, 237–243 (2019). https://doi.org/10.1007/s12185-019-02673-3

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  • DOI: https://doi.org/10.1007/s12185-019-02673-3

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