Session: 906. Outcomes Research – Myeloid Malignancies: Poster I
Hematology Disease Topics & Pathways:
Research, adult, epidemiology, Clinical Practice (Health Services and Quality), Clinical Research, registries, survivorship, Study Population, Human
Methods: Prospective cohort study conducted from August to December 2021 through the application of interviews with hematologists from the Federal University of Bahia Clinics Hospital (HUPES-UFBA). Adult patients (age≥18) with HM admitted to the Hematology ward of Clinics Hospital during the study period were included and the SQ was answered by the physicians responsible for the patients at the time of inclusion. Clinical information was extracted from medical records.
Results: During the study period, 76 patients were included after exclusion criteria (age<18 and not HM) were applied. Median age was 48.8 years-old (SD 17.2), and most participants were female (58%). Regarding the diagnosis, 38.2% had acute leukemia, 25% had R/R (refractory/relapsed) lymphoma, and 30.3% had R/R multiple myeloma. Forty-nine patients (64.5%) had poor performance status (ECOG 3 or 4), and most patients (57.9%) were receiving disease-modifying therapy. Physicians responded “No, I would not be surprised” (positive, SQ+) for 43 (57%) patients. After 12 months, 35 patients (46%) had died, from which 31 (89%) were in the group SQ - “No”. The sensitivity of the SQ was 88%, and specificity was 72%. The positive predictive value was 72%, negative predictive value was 88%, and accuracy was 79%. Notably, although clinicians found that 43 (57%) patients had a life expectancy of less than 12 months, only 24 (31.6%) were being followed-up with PC at the time of the interview.
Conclusion: The SQ has been shown to correctly estimate death among 68.3% of patients with blood cancers in the previous literature. In our study, the SQ demonstrated high sensitivity and potential clinical use. However, even within a center with full availability of a PC team dedicated to patients with advanced diseases and high morbidity and mortality, such as acute leukemia, the hematology team had rarely referred patients to PC. Despite advances on the importance of PC in the care of patients with HM, there is still an important delay when requesting the involvement of this specialty. Thus, effective strategies in order to integrate PC within this scenario are crucial.
Disclosures: Crusoe: Amgen, BMS, Janssen, Sanofi, Takeda: Honoraria; Janssen: Research Funding. Salvino: Amgen: Consultancy; Pfizer: Consultancy, Honoraria, Research Funding, Speakers Bureau; MSD: Consultancy, Honoraria, Speakers Bureau; F. Hoffmann-La Roche Ltd: Consultancy, Honoraria, Research Funding, Speakers Bureau; Novartis: Consultancy, Honoraria, Research Funding, Speakers Bureau; AstraZeneca: Consultancy, Honoraria, Speakers Bureau; Takeda: Consultancy, Honoraria, Research Funding, Speakers Bureau; OrphanDrugs: Consultancy; Abbvie: Consultancy, Honoraria, Speakers Bureau; Gilead: Honoraria, Speakers Bureau; ABHH: Membership on an entity's Board of Directors or advisory committees; SBTMO: Membership on an entity's Board of Directors or advisory committees.
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