A number of studies presented at the 67th American Society of Hematology (ASH) Annual Meeting and Exposition spotlight how re-examining existing practices can illuminate new approaches, or the need for new approaches, to improving care and outcomes for patients living with blood disorders.
“These four studies all seek in different ways to improve care and outcomes for patients – by addressing care gaps, challenging long-held beliefs, and identifying equity gaps and unmet needs,” said Prof Adam Cuker, Professor of Medicine and Director of the Penn Comprehensive Haemophilia and Thrombosis Programme, University of Pennsylvania Perelman School of Medicine in Philadelphia, US, who moderated the press briefing ‘More than medicine: Improving patient experience and access’. “These findings speak to the ongoing importance of research that questions existing practices and zeroes in on how to achieve better outcomes for patients.”
Two studies focused on iron deficiency and iron-deficiency anaemia, related disorders that are underdiagnosed and undertreated in certain populations, including reproductive-age women.
Findings from the first study indicate that iron deficiency is not only a common problem among pregnant patients, but can be readily addressed with a standardised approach to screening and treatment. Results from this multidisciplinary quality improvement initiative demonstrated significant increases within a year in screening rates, infusions of intravenous (IV) iron, and median haemoglobin levels among pregnant patients. The second study addressed iron-deficiency anaemia in patients with a simultaneous acute bacterial infection. Its results challenge the long-time practice of not giving IV iron to these patients because of concern that doing so could worsen the infection. Analysis of data from more than 85,000 patients hospitalised with both iron-deficiency anaemia and an acute bacterial infection found that, on the contrary, treatment with IV iron increased patients’ haemoglobin levels and significantly improved their survival.
The remaining two studies highlight gaps in outcomes and unmet needs for specific groups of patients with blood cancers. The first study – one of the largest to date to compare outcomes for black and white patients with an aggressive form of leukaemia who received treatment in clinical trials supported by the National Cancer Institute (a component of the US National Institutes of Health) – found that black patients are diagnosed at younger ages and have significantly poorer survival than their white counterparts. Moreover, among patients with a common genetic mutation typically associated with more favour- able treatment outcomes, survival for black patients was less than half that for white patients.
The final study shed light on the significant financial impact of cancer treatment on the families of children undergoing chemotherapy for acute lymphoblastic leukaemia – the most common paediatric cancer.
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