Abstract 5273
Background
International consensus supports early integration of SPC in oncological disease. Haematological malignancies differ in nature from solid site tumours. Remitting and relapsing trajectories, late salvage treatments, and divergent outcomes make for difficult prognostication and traditional markers of ‘good’ end of life care may not translate well to this group. However, disease is often incurable and physical and psychological symptom burden high, making SPC input essential. The authors propose an integrated care model to achieve this, utilising predefined triggers to identify unmet need and to guide SPC involvement from time of diagnosis. Such a service, “Triggers”, has been successfully developed for other cancer groups at the TCC. Through improved understanding of current practices we plan to tailor this service to meet the unique needs of the haematology patient group.
Methods
A retrospective audit of electronic records was completed for patients dying of haematology malignancy in the 12 months to 31/3/18. Data relating to SPC referral, DNAR documentation, active interventions, place of death and diagnosis sub-type was collected.
Results
Of 108 patients identified, 67 died in hospitals, including 43 at the TCC. Of 26 deaths within 30 days of discharge from the TCC, 100% of those with a previous SPC referral (16) died in the community while 80% of those without (10) died in a local hospital.Table:
1611P
Totals / Range | Median | |
---|---|---|
Deaths in year ending 31/3/19 | 108 | |
Documented referrals to SPC | 72/108 | |
Time from Diagnosis to death | 0 – 23 years | 3 years |
Time from SPC referral to death | 0 – 10 years | 6 days |
For Tertiary Centre in-patient deaths only: | ||
Number of TCC in-patient deaths | 43 | |
Chemotherapy in last 30 days | 25/43 | |
Blood transfusion in last 30 days | 38/43 | 2 days pre death |
Platelets in last 30 days | 34/43 | 3 days pre death |
TPN in last 30 days | 11/43 | 4 days pre death |
Time from DNAR record to death | 0 – 30 days | 3 days pre death |
Conclusions
Haematological intervention remains frequent up until death but SPC involvement is relatively delayed. Later SPC input is expected to limit effective relationship building and advance care planning and the data shows differences in place of death for those with and without SPC referral. Results suggest an opportunity to support patient-centred care through the development of an integrated service with early SPC accessibility and a consultative survey is underway to ascertain how this might best be achieved.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3309 - Heat Shock Protein 90 chaperones and Protein Kinase D3 regulates androgen-independent prostate cancer development
Presenter: Attila Varga
Session: Poster Display session 1
Resources:
Abstract
3441 - The SWI/SNF driven reprograming for the AR cistrome is NSD2 dependent
Presenter: Katia Ruggero
Session: Poster Display session 1
Resources:
Abstract
1659 - IGF1R inhibition affects the survival of HT29 cancer cells by alterations of the TLR9- and autophagy signaling
Presenter: Györgyi Műzes
Session: Poster Display session 1
Resources:
Abstract
1379 - Characterization of atypical dMMR (deficient MisMatch Repair) tumors: a study from a large cohort of 4948 cases
Presenter: Marion Jaffrelot
Session: Poster Display session 1
Resources:
Abstract
1657 - Modulation of TLR9-dependent autophagy response via inhibition of c-Met signaling influences the survival of HT29 cancer cells
Presenter: Ferenc Sipos
Session: Poster Display session 1
Resources:
Abstract
3045 - Positive Feedback Activation of Notch Signal by Obesity Enhances Colorectal Tumorigenicity
Presenter: Dake Chu
Session: Poster Display session 1
Resources:
Abstract
2285 - The Pathological and Functional Roles of BRPF1 in Hepatocellular Carcinoma
Presenter: Lai Hung Carol Cheng
Session: Poster Display session 1
Resources:
Abstract
3210 - Protein tyrosine phosphatase non-receptor type 3 (PTPN3) could be a new therapeutic target for pancreatic cancer.
Presenter: Akio Yamasaki
Session: Poster Display session 1
Resources:
Abstract
3920 - A Novel bispecific BCMAxCD3 T cell engaging antibody that treat multiple myeloma (MM) with minimal cytokine serection
Presenter: Zhenyu Li
Session: Poster Display session 1
Resources:
Abstract
2691 - Quantitative spatial profiling of lymphocyte-activation gene 3 (LAG-3)/major histocompatibility complex class II (MHC II) interaction in gastric and urothelial tumors
Presenter: Cyrus Hedvat
Session: Poster Display session 1
Resources:
Abstract