Trainees in hematology, hematopoietic cell transplantation (HCT), and cellular therapy (CT) face complex patient care scenarios that require advanced skills in symptom management, communication, and shared decision-making. However, many report a lack of formal education and training in managing these situations, particularly in relation to palliative care [1]. Recognizing this unmet need, the EBMT Trainee Committee conducted a global survey of early-career clinicians to identify key barriers to the effective integration of palliative care.
Advancements in hematology accelerated after the discovery of stem cell transplantation in the mid-1900s and continued to rise last few decades, offering potentially curative treatments for a wide range of diseases [2]. However, HCT and more novel CT approaches in the field are incredibly complex, requiring a unique set of patient care challenges, as the intensive nature of these approaches often results in substantial complications during and after treatment as well as in long-term follow-up [3]. Patients frequently endure a high burden of physical symptoms such as graft-versus-host disease, infections, and cytokine release syndrome, which can significantly impair their quality of life. The need for extended hospital stays and intensive care units further complicates patient care and quality of life. Beyond physical symptoms, patients and families face substantial psychosocial distress from isolation and debilitating side effects. The risk of relapse, combined with severe morbidity and mortality, leads to profound prognostic uncertainty throughout the disease trajectory. Patients must manage complex treatment decisions, financial strains, and emotional burnout while balancing the hope for a cure against the reality of potential treatment failure [4]. This intricate landscape of intense hematologic care demands parallel planning for both curative efforts and holistic comfort, establishing palliative care as a foundational element of high-quality patient management.
