Report calls for better palliative and EOL care for patients that relapse following transplant

Haematological disorders of the blood and bone marrow, such as leukaemia, are commonly treated with a bone marrow transplant. However relapse is common and often leads to treatment failure and death.

Despite this there is little research available to guide nurses through the process of palliative and end-of-life (EOL) care for patients that relapse following bone marrow transplant.

Survey results by Griffith University’s National Centre for Research Excellence in Nursing (NCREN) have found senior haematology nurses in Australia and New Zealand believe relapsed transplant patients are often referred to palliative care services too late in their cancer journey, with little consideration given to EOL planning.

Elise Button from the Griffith Health Institute and the Royal Brisbane Hospital conducted a survey, which was distributed to the most advanced nurse at each of the major bone marrow transplant centres in Australia and New Zealand.

Presenting her findings at the Haematology Association of Australia Annual Meeting 2013 on the Gold Coast, she said senior haematology nurses are overwhelmingly supportive of better integration of palliative and EOL care for patients that relapse post transplant.

“Nurses reported they felt haematologists often referred patients to palliative care services in the terminal phase and most end-of-life discussions occurred in the terminal phase,” Mrs Button said.

“Respondents felt early palliative care integration was beneficial for patients and families giving them more time to think over and discuss EOL options such as cessation of active treatment, place of death or not for resuscitation orders.”

The results of the survey confirm findings of a retrospective chart review of deceased relapsed bone marrow transplant patients.

The report is calling for more research education and support of patients that relapse following bone marrow transplantation.