Palliative care in patients with haematological neoplasms: An integrative systematic review

Palliat Med. 2018 Jan;32(1):79-105. doi: 10.1177/0269216317735246. Epub 2017 Nov 13.


Background: Palliative care was originally intended for patients with non-haematological neoplasms and relatively few studies have assessed palliative care in patients with haematological malignancies.

Aim: To assess palliative care interventions in managing haematological malignancies patients treated by onco-haematology departments.

Design: Integrative systematic review with data extraction and narrative synthesis (PROSPERO #: CRD42016036240).

Data sources: PubMed, CINAHL, Cochrane, Scopus and Web-of-Science were searched for articles published through 30 June 2015. Study inclusion criteria were as follows: (1) published in English or Spanish and (2) containing data on palliative care interventions in adults with haematological malignancies.

Results: The search yielded 418 articles; 99 met the inclusion criteria. Six themes were identified: (1) end-of-life care, (2) the relationship between onco-haematology and palliative care departments and referral characteristics, (3) clinical characteristics, (4) experience of patients/families, (5) home care and (6) other themes grouped together as 'miscellany'. Our findings indicate that palliative care is often limited to the end-of-life phase, with late referral to palliative care. The symptom burden in haematological malignancies patients is more than the burden in non-haematological neoplasms patients. Patients and families are generally satisfied with palliative care. Home care is seldom used. Tools to predict survival in this patient population are lacking.

Conclusion: Despite a growing interest in palliative care for haematological malignancies patients, the evidence base needs to be strengthened to expand our knowledge about palliative care in this patient group. The results of this review support the need to develop closer cooperation and communication between the palliative care and onco-haematology departments to improve patient care.

Keywords: Haematological malignancies; dying and end of life; haematologic neoplasms; palliative care; palliative medicine; terminal care.

Publication types

  • Systematic Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Hematologic Neoplasms / nursing*
  • Home Care Services / organization & administration*
  • Home Care Services / statistics & numerical data
  • Hospice Care / organization & administration*
  • Hospice Care / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Palliative Care / organization & administration*
  • Palliative Care / statistics & numerical data
  • Terminal Care / organization & administration*
  • Terminal Care / statistics & numerical data