Patient-reported patterns of follow-up care in the 'Aftercare in Blood Cancer Survivors' (ABC) study

J Cancer Res Clin Oncol. 2023 Sep;149(12):10531-10542. doi: 10.1007/s00432-023-04889-7. Epub 2023 Jun 8.

Abstract

Background: Follow-up care provides long-term support for cancer survivors. Little is known about follow-up care in hematologic malignancies.

Methods: Our questionnaire-based study included blood cancer survivors diagnosed at the University Hospital of Essen before 2010, with a ≥ 3-year interval since the last intense treatment. The primary goal of the retrospective study was the identification and characterization of follow-up institutions.

Results: Of 2386 survivors meeting the inclusion criteria, 1551 (65.0%) consented to participate, with a follow-up duration > 10 years in 731. The university hospital provided care for 1045 participants (67.4%), non-university oncologists for 231 (14.9%), and non-oncological internists or general practitioners for 203 (13.1%). Seventy-two participants (4.6%) abstained from follow-up care. The disease spectrum differed among follow-up institutions (p < 0.0001). While allogeneic transplant recipients clustered at the university hospital, survivors with monoclonal gammopathy, multiple myeloma, myeloproliferative disorders, or indolent lymphomas were often seen by non-university oncologists, and survivors with a history of aggressive lymphoma or acute leukemia by non-oncological internists or general practitioners. Follow-up intervals mirrored published recommendations. Follow-up visits were dominated by conversations, physical examination, and blood tests. Imaging was more often performed outside than inside the university hospital. Satisfaction with follow-up care was high, and quality of life was similar in all follow-up institutions. A need for improvement was reported in psychosocial support and information about late effects.

Conclusions: The naturally evolved patterns identified in the study resemble published care models: Follow-up clinics for complex needs, specialist-led care for unstable disease states, and general practitioner-led care for stable conditions.

Keywords: Allogeneic transplantation; Blood cancer; Follow-up care; Leukemia; Lymphoma; Myeloproliferative neoplasm; Quality of life.

MeSH terms

  • Aftercare
  • Cancer Survivors* / psychology
  • Hematologic Neoplasms* / epidemiology
  • Hematologic Neoplasms* / therapy
  • Humans
  • Multiple Myeloma*
  • Patient Reported Outcome Measures
  • Quality of Life
  • Retrospective Studies
  • Survivors