Clinical Trials Logo

Clinical Trial Summary

The aim of the study is to pilot and evaluate a new integration model between a Specialised Palliative Care (SPC) intervention and standard hematological care in an Italian hospital. This is a feasibility mix-methods study, where a sample of advanced hematological patients are randomised to receive integrated hematological care and a SPC intervention or standard hematological care throughout the course of the predictive last active treatment.


Clinical Trial Description

The most recent World Health Organization (WHO) definition of palliative care advocates that palliative care principles "…should be applied as early as possible in the course of any chronic, ultimately fatal illness". The difference with the previous WHO vision was substantial, as the earlier definition recommended Palliative Care to patients not responsive to curative therapy, limiting its role to the last period of life.

Evidence about the effectiveness of an early integration of palliative care has begun to emerge in the last years, primarily for cancer patients. The results of experimental studies, showed the effectiveness of early integration of palliative in the management of advanced illness, in improving quality of life, reducing consumption of resources, and possibly increasing survival. These data were also confirmed in Italy.

Hematological advanced patients suffer from a very high symptoms burden, psychological, spiritual, social and physical symptoms. They are very similar to oncological advanced patients. Hematologic patients during the last 30 days of their life are more frequently admitted in Hospital setting, emergency departments and high care ward than oncological patients, they received more aggressive treatments and more chemotherapy or biologic active treatments than oncologic patients.

Looking to WHO's palliative care definition and hematologic patients' symptoms burden it's simple to imagine that an early access to palliative care service could be the answer, as it was for advanced oncologic patients. The rational of the new vision lied on the recognition that palliative care had the potential to improve quality of life of patients and their family members during the whole trajectory of an incurable disease, through an effective management of psychological and physical symptoms, appropriate relationships, effective communication and support in decision-making.

In addition, even if WHO definition is referred to incurable patients, recent experience on Palliative care and Hematology is also about potentially curative patients.

Nonetheless, access to palliative care in hematologic patients care results totally absent or confined in the last days of life.There is a resistance by hematologic specialists to address patients to a palliative care service because of the possible misunderstanding between active treatment and palliative care assistance, identified from many professionals as terminal care A call to a new model of integration between palliative care and hematologic service is strong; for some authors just from the beginning of an advanced disease and for other authors modelled on the different patients' needs.

The aim of the study is to pilot a new model of integration for advanced hematological cancer between hematology and palliative care. Eligible patients will be at their last active treatment (chemotherapy or immunotherapy) as decided by hematologists.

The primary aim is to evaluate the feasibility, acceptability and efficacy of this novel intervention.

The evaluation procedure will be evaluated for feasibility and applicability To the investigators knowledge this is the first trial on an integrative model between palliative care and hematology for an advanced hematological population.

Primary aim

To evaluate the feasibility of integrated versus standard involvement of palliative team for hematological advanced patients.

Secondary aims to evaluate the efficacy of this new model on Quality of Life (QoL) until 6 months after the enrollment.

to evaluate the impact of the intervention on care pathways (number of chemotherapies in the last 30 days, number of exams, length of stay in Hospital or Hospice, access to emergency department, setting of death and so on) to evaluate the acceptability of the intervention by patients, professionals and caregivers. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT03743480
Study type Interventional
Source Arcispedale Santa Maria Nuova-IRCCS
Contact silvia tanzi, md
Phone +390522295325
Email silvia.tanzi@ausl.re.it
Status Recruiting
Phase N/A
Start date November 21, 2018
Completion date November 2020

See also
  Status Clinical Trial Phase
Completed NCT03483194 - Therapeutic Virtual Reality : Impact on the Management of Pain and Anxiety Related to Hematology Care (REVEH) Phase 2/Phase 3
Recruiting NCT03735992 - Mind-body Medicine for Patients With Malignant Hematological Diseases N/A
Recruiting NCT04959175 - Phase I/II Study to Reduce Post-transplantation Cyclophosphamide Dosing for Older or Unfit Patients Undergoing Bone Marrow Transplantation for Hematologic Malignancies Phase 1/Phase 2
Withdrawn NCT04275154 - Immunological Parameters, Neurocognitive Changes, Activity, & Driving Fitness in Patients Undergoing CAR-T Cell Therapy
Completed NCT00997386 - Reduced Intensity Allogeneic PBSCT to Treat Hematologic Malignancies and Hematopoietic Failure States Phase 2
Terminated NCT00957580 - Trial of Pimasertib in Hematological Malignancies Phase 2
Completed NCT00389428 - Multicenter Study of CPX-351(Cytarabine:Daunorubicin) Liposome Injection in Patients With Advanced Hematologic Cancer. Phase 1
Completed NCT02193880 - Safety of Post-transplant Alpha-beta Depleted T-cell Infusion Following Haploidentical Stem Cell Transplant (Haplo SCT) N/A
Recruiting NCT00071045 - Collection of Tissue Specimens From Patients With Solid Tumors or Blood Disorders and Their HLA-Compatible Family Members
Not yet recruiting NCT05054231 - Immunological Profile for Patients Treated With CAR-T Cells N/A
Completed NCT02650791 - Platelet Transfusion Requirements in Hematopoietic Transplantation Pilot Study Phase 3
Completed NCT01362179 - National Marrow Donor Program Long-Term Donor Follow-Up
Terminated NCT02900248 - CureOne Registry: Advanced Malignancy or Myelodysplasia, Tested by Standard Sequencing and Treated by Physician Choice
Terminated NCT03648372 - A Study of TAK-981 in People With Advanced Solid Tumors or Cancers in the Immune System Phase 1/Phase 2
Recruiting NCT03320915 - Efficacy and Safety of High Dose Vitamin D Supplementation in Patients Undergoing HSCT Phase 2
Terminated NCT02895529 - A Study Comparing the Efficacy of Intravenous Followed by Oral Itraconazole With Intravenous Caspofungin For Empiric Antifungal Therapy in Neutropenic Participants With Hematological Malignancy Phase 4
Active, not recruiting NCT03680092 - Comparing Cyclophosphamide and Abatacept With Standard of Care Treatment Following Stem Cell Transplantation Phase 2
Recruiting NCT03083327 - Prophylactic Early PN in HPT/BMT N/A
Completed NCT02635984 - Study of FOND Versus FOND+O for the Prevention of CINV in Hematology Patients Receiving Highly Emetogenic Chemotherapy Regimens Phase 3
Completed NCT01275534 - Symptom Experience and Self-management After Haematopoietic Stem Cell Transplantation N/A