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Hematologic Challenges at the End-of-Life

Program: Education Program
Hematology Disease Topics & Pathways:
Bleeding and Clotting, Clinical Practice (Health Services and Quality), Hemoglobinopathies, Diseases, Treatment Considerations
Saturday, December 7, 2024: 2:00 PM-3:15 PM
Room 6A (San Diego Convention Center)

Description:
Management of hematologic conditions for patients at the end of life is both a challenge and an opportunity to provide evidence-based, compassionate care. Care of seriously ill patients entails specific considerations—including incorporating life expectancy, addressing symptom burden, and navigating hospice—that apply across the spectrum of hematologic diseases. Further, there is a growing, multidisciplinary evidence base to support treatment decision-making that this session will review. First, we will discuss optimization of end-of-life care in transfusion-dependent hematologic malignancies. We will then focus on a strategy for management of anticoagulant medications in those with limited life expectancy. Finally, we will address prognostication and palliative care in sickle cell disease.

Dr. Loh will highlight challenges and barriers in implementing timely end-of-life-care and potential strategies to overcome these barriers for patients with transfusion-dependent hematologic malignancies.

Dr. Park's talk "Anticoagulation at the End of Life: Whether, When, and How to Treat,"  will focus on state-of-the-art evidence from hematology and palliative care science to inform management of anticoagulant medications in patients with life-limiting illness. Dr. Parks will discuss the complexities of anticoagulation at the end of life, opportunities to enhance our knowledge, and outline an approach to care that is based on patients’ values.  

Dr. Johnston will discuss challenges in providing high quality end-of-life care for people with SCD, including disease-related, communication-related, and systemic-related challenges and discuss strategies to overcome these challenges, including use of primary and specialty palliative care.

Chair:
Anna L. Parks, MD, University of Utah Health
Disclosures:
No relevant conflicts of interest to declare.
Management of hematologic conditions for patients at the end of life is both a challenge and an opportunity to provide evidence-based, compassionate care. Care of seriously ill patients entails specific considerations—including incorporating life expectancy, addressing symptom burden, and navigating hospice—that apply across the spectrum of hematologic diseases. Further, there is a growing, multidisciplinary evidence base to support treatment decision-making that this session will review. First, we will discuss optimization of end-of-life care in transfusion-dependent hematologic malignancies. We will then focus on a strategy for management of anticoagulant medications in those with limited life expectancy. Finally, we will address prognostication and palliative care in sickle cell disease.

Dr. Loh will highlight challenges and barriers in implementing timely end-of-life-care and potential strategies to overcome these barriers for patients with transfusion-dependent hematologic malignancies.

Dr. Park's talk "Anticoagulation at the End of Life: Whether, When, and How to Treat,"  will focus on state-of-the-art evidence from hematology and palliative care science to inform management of anticoagulant medications in patients with life-limiting illness. Dr. Parks will discuss the complexities of anticoagulation at the end of life, opportunities to enhance our knowledge, and outline an approach to care that is based on patients’ values.  

Dr. Johnston will discuss challenges in providing high quality end-of-life care for people with SCD, including disease-related, communication-related, and systemic-related challenges and discuss strategies to overcome these challenges, including use of primary and specialty palliative care.

Kah Poh (Melissa) Loh, MD

University of Rochester, Rochester, NY

Anna L. Parks, MD

Department of Medicine, Division of Hematology & Hematologic Malignancies, University of Utah Health, Salt Lake City, UT

Emily E Johnston, MD

Pediatrics, University of Alabama At Birmingham, Birmingham, AL

See more of: Education Program