Japanese Journal of Clinical Oncology Advance Access published online on June 17, 2009
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyp064
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© The Author (2009). Published by Oxford University Press. All rights reserved
Retrospective Study on Home Care for Patients with Hematologic Malignancies
1 Division of Social Communication System for Advanced Clinical Research, The Institute of Medical Science, University of Tokyo, Tokyo
2 Aozora Medical Clinic, Chiba
3 Kajiwara Clinic, Tokyo
4 Morioka Home Care Clinic, Iwate
5 Department of Family Medicine, Kameda Medical Center, Chiba
6 Nakano Home Care Clinic, Kagoshima
7 Department of Internal Medicine, The Institute of Medical Science, University of Tokyo, Tokyo, Japan
For reprints and all correspondence: Yuko Kodama, Division of Social Communication System for Advanced Clinical Research, the Institute of Medical Science, the University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo 108-8639, Japan. E-mail: alice-smn{at}umin.net
Received March 18, 2009; accepted May 16, 2009
Objective: There is a lack of sufficient information on the employment of home care for the treatment of hematologic malignancies.
Methods: We provided home care to 580 patients from 1 January through 31 October 2007. Patients with hematologic malignancies were selected from these 580 patients; subsequently, by reviewing their medical records.
Results: The main clinical condition in 15 (2.6%) of 580 patients was hematologic malignancies. The median age of the patients was 78 years (range, 64–92). Of the 15 patients, 12 showed a performance status (PS) of 3–4, and the condition of 6 patients was complicated with dementia. Food intake via the oral route was possible in 14 patients. These patients were administered palliative care. Among the seven patients who required pain control, four had been opioid users; however, none had used anticancer drugs for pain relief. Furthermore, three patients received blood transfusion. Although three patients developed severe complications (acute appendicitis, pneumonia and hyperglycemia), we were able to treat all cases adequately. Eight patients died at home due to aggravation of the primary diseases. The remaining seven patients were transferred to other hospitals for the treatment of complications or for the convenience of their respective families.
Conclusions: Even patients with hematologic malignancies could be candidates for home care if their underlying diseases are slowly progressive, and they can sustain themselves by oral intakes. Dementia and poor PS are not contraindicated to it.
Key Words: home care • hematologic malignancy • lymphoma • chemotherapy • palliative care