A new study, presented at ASH Annual Meeting and Exposition in Atlanta, has shown that patients with hematologic malignancies received more aggressive care at the end of life than patients with solid tumors. 

In addition, racial minorities with hematologic malignancies had lower rates of advance directive documentation and received significantly more aggressive care at the end of life than white individuals with blood cancers.

“Slowly over the last couple years, there has been more of a recognition of trying to figure out if those disparities exist [for patients with hematologic cancers] and, subsequently, to figure out what to do about them,” said Kedar Kirtane, fellow in the hematology/oncology fellowship program at University of Washington.

Kirtane and his colleagues assessed differences in hospitalization use patterns and documentation of advance care planning among 9,469 patients with solid tumors or hematologic malignancies.

All patients underwent treatment at University of Washington Medicine and died between 2010 and 2015. In a subgroup analysis that included those with hematologic malignancies, researchers assessed differences in outcomes associated with racial minority status.

Patients with hematologic malignancies appeared significantly more likely to receive aggressive hospital-based care, including hospitalization for 14 or more days and multiple hospital admissions during the last 30 days of life.

Additionally, the researchers found that those with hematologic malignancies appeared more likely to receive ICU care and die in the hospital, when compared with those who had solid tumor malignancies,

Results of the subgroup analysis showed racial minorities with hematologic malignancies were less likely than white individuals to have advance directive documentation, and they also were more likely to be hospitalized and receive ICU care within the last 30 days of life.