Leukemia Research
Volume 27, Issue 6 , Pages 481-488, June 2003

The final phase in acute myeloid leukaemia (AML)

A study on bleeding, infection and pain

  • Ann Marie Stalfelt

      Affiliations

    • Department of Public Health and Caring Sciences/Social Medicine, Uppsala University, Uppsala Science Park, SE-751 85 Uppsala, Sweden
    • Corresponding Author InformationCorresponding author. Present address: Department of Haematology, Örebro University Hospital, SE 701 85 Örebro, Sweden. Tel.: +46-19-611-88-40; fax: +46-19-602-4580.
  • ,
  • Håkan Brodin

      Affiliations

    • TNO Prevention and Health, Leiden, The Netherlands
  • ,
  • Solveig Pettersson

      Affiliations

    • Department of Haematology, Medical Centre Hospital, Örebro, Sweden
  • ,
  • Anna Eklöf

      Affiliations

    • Department of Haematology, Medical Centre Hospital, Örebro, Sweden

Received 30 January 2002; accepted 4 October 2002.

Abstract 

To increase the knowledge of the final phase of acute myeloid leukaemia (AML) a retrospective review of the medical and nursing records of 106 adult patients with AML who had died in 1995–1997 was made. A total of 27 patients were treated with curative intent at the time of death and 79 patients were prescribed palliative care. From the documentation, an evaluation of the frequency and severity of bleeding and pain episodes was made during their last week in life, and the occurrence of infection criteria was studied. Notations on bleeding were found in 44%, infection in 71% and pain in 76% of the patients. In 54% of the morphine administration days, no information on the effect of given morphine treatment was registered. To give AML patients in the final phase, the best possible treatment, skills in palliative medicine and palliative care are important.

Abbreviations: ABT, antibiotic treatment, AFT, antifungal treatment, AML, acute myeloid leukaemia, BMT, bone marrow transplantation, CR, complete remission, HBHC, hospital-based home care, IV, intravenous, ICU, intensive care unit, MCH, medical centre hospital, UD, university department, VAS, visual analogue scale

Keywords: Acute leukaemia, Infection, Bleeding, Pain, Nursing documentation, Palliative care, Palliative medicine, Quality of life

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PII: S0145-2126(02)00262-X

doi:10.1016/S0145-2126(02)00262-X

Leukemia Research
Volume 27, Issue 6 , Pages 481-488, June 2003