BackgroundInformation about follow‐up care in blood cancer survivors is limited. The questionnaire‐based “Aftercare in Blood Cancer Survivors” (ABC) study aimed to identify patterns of follow‐up care in Germany and compare different types of follow‐up institutions.MethodsThe study's 18‐month prospective part compared the follow‐up institutions identified in the preceding retrospective part (academic oncologists, community oncologists, primary care physicians). The questionnaires were completed by the follow‐up physicians.ResultsOf 1070 physicians named by 1479 blood‐cancer survivors, 478 (44.7%) consented to participate. For provision of care, most oncologists relied on published guidelines, while most primary care physicians depended on information from other physicians. Survivors with a history of allogeneic transplantation or indolent lymphoma were mainly seen by academic oncologists, whereas survivors with monoclonal gammopathy, multiple myeloma, or myeloproliferative disorders were often seen by community oncologists, and survivors with a history of aggressive lymphoma or acute leukemia by primary care physicians. Detection of relapse and secondary diseases was consistently viewed as the most important follow‐up goal. Follow‐up visits were most extensively documented by academic oncologists (574 of 1045 survivors cared for, 54.9%), followed by community oncologists (90/231, 39.0%) and primary care physicians (51/203, 25.1%). Relapse and secondary disease detection rates and the patients' quality of life were similar at the three institutions. Laboratory tests were most often ordered by academic oncologists, and imaging by primary care physicians. Psychosocial issues and preventive care were more often addressed by primary care physicians than by oncologists.ConclusionsPatients at high risk of relapse or late complications were preferentially treated by academic oncologists, while patients in stable condition requiring continuous monitoring were also seen by community oncologists, and patients with curable diseases in long‐term remission by primary care physicians. For the latter, transfer of follow‐up care from oncologists to well‐informed primary care providers appears feasible.

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成人血癌幸存者的后续护理模式——健康相关结果、资源利用和生活质量的前瞻性评估

背景有关血癌幸存者随访护理的信息有限。基于问卷的“血癌幸存者的术后护理”(ABC) 研究旨在确定德国的随访护理模式并比较不同类型的随访机构。方法该研究的 18 个月前瞻性部分比较了确定的随访机构在前面的回顾性部分（学术肿瘤学家、社区肿瘤学家、初级保健医生）。问卷由随访医生完成。结果在 1479 名血癌幸存者指定的 1070 名医生中，478 名 (44.7%) 同意参与。为了提供护理，大多数肿瘤学家依赖已发布的指南，而大多数初级保健医生则依赖其他医生的信息。有同种异体移植史或惰性淋巴瘤病史的幸存者主要由学术肿瘤学家接诊，而患有单克隆丙种球蛋白病、多发性骨髓瘤或骨髓增殖性疾病的幸存者则经常由社区肿瘤科医生接诊，而有侵袭性淋巴瘤或急性白血病病史的幸存者则由初级保健接诊医生。检测复发和继发性疾病一直被视为最重要的随访目标。学术肿瘤学家（1045 名幸存者中的 574 名接受护理的幸存者中的 574 名，54.9%）记录了最广泛的随访访问，其次是社区肿瘤学家（90/231，39.0%）和初级保健医生（51/203，25.1%）。这三个机构的复发和继发疾病检出率以及患者的生活质量相似。实验室检查通常由学术肿瘤学家进行，影像学检查则由初级保健医生进行。与肿瘤科医生相比，初级保健医生更常解决心理社会问题和预防性护理。 结论 复发或晚期并发症高风险的患者优先由学术肿瘤科医生治疗，而需要持续监测的病情稳定的患者也由社区肿瘤科医生和患者接诊初级保健医生可长期缓解可治愈的疾病。对于后者，将后续护理从肿瘤科医生转移到消息灵通的初级保健提供者似乎是可行的。