Approximately 25,000 individuals in the United States die annually from leukemia. These individuals often require transfusions; however, hematologic oncologists have differing beliefs about transfusions near the end of life, which may delay or hinder these patients from enrolling in hospice. In order to gain a better understanding, researchers examined data from the Surveillance, Epidemiology, and End Results-Medicare database. Data from Medicare patients (median age of 79 years) with acute and chronic leukemias who died between 2001-2011 were analyzed. Twenty percent of the 21,033 leukemia patients had 2 or more transfusions 30 days before hospice enrollment or death. Although hospice enrollment increased from 35% in 2001 to 49% in 2011, transfusion-dependent patients were enrolled for a shorter number of days (6 vs. 11 days, P<0.001). Regardless of transfusion dependence, leukemia patients enrolled in hospice were more likely to have better of end-of-life care and lower Medicare spending than those not enrolled in hospice. Incorporating transfusions into end-of-life hospice care (or special palliative care provided earlier in the diagnosis) for leukemia patients should be considered since longer hospice stays could benefit the majority of these patients.
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