Hospice programmes are important for providing end-of-life care to patients with life-limiting illnesses. Hospice enrolment improves quality of life for patients with advanced cancer and reduces the risk of depression for caregivers. Despite the clear benefits of hospice care, patients with haematological malignancies have the lowest rates of enrolment among patients with any tumour subtype. Furthermore, when patients with haematological disorders do enrol into hospice care, they are more likely to do so within 3 days of death than are patients with non-haematological malignancies. Although reasons for low and late hospice use in this population are multifactorial, a key barrier is limited access to blood transfusions in hospice programmes. In this Viewpoint, we discuss the relationship between transfusion dependence and hospice use for patients with blood cancers. We suggest that rather than constraining patients into either transfusion or hospice models, policies that promote combining palliative transfusions with hospice services are likely to optimise end-of-life care for patients with haematological malignancies.

中文翻译：

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血液系统恶性肿瘤患者不必在输血和临终关怀护理之间进行选择。

临终关怀计划对于为患有生命受限疾病的患者提供临终关怀至关重要。临终关怀的登记可以改善晚期癌症患者的生活质量，并降低护理人员患抑郁症的风险。尽管临终关怀治疗具有明显的好处，但在任何肿瘤亚型患者中，血液系统恶性肿瘤患者的入选率最低。此外，当血液系统疾病患者确实接受临终关怀服务时，与非血液系统恶性肿瘤患者相比，他们在死亡后三天内更有可能接受临终关怀服务。尽管在该人群中使用晚期和晚期临终关怀的原因是多方面的，但主要的障碍是临终关怀计划中输血的机会有限。在这个观点上，我们讨论了血癌患者的输血依赖和临终关怀使用之间的关系。我们建议，不要将患者限制在输血或临终关怀模式中，而应采取政策，将姑息性输血与临终关怀服务相结合，可能会优化血液系统恶性肿瘤患者的临终护理。