How do you manage patients desiring home hospice but with severe thrombocytopenia and/or anemia due to advanced malignancy?

As a pediatric hematologist/oncologist and pediatric palliative care physician, I can only speak to our approach with children, which may be quite different than the adult world.

In our community, we are not able to provide blood or platelet transfusions in the home. For children who are profoundly ...

Hospice is a type of palliative care delivered for patients with terminal prognosis and life expectancy of 6 months or fewer. Generally, hospice companies will not provide supportive transfusions of packed red blood cells or platelets. Similarly, growth factors are not part of the routine formulary ...

Many factors may play a role, and comorbidities, ability for ambulatory care and transfer and perhaps important projected life-expectancy would be all-important decision-making considerations. For home hospice care, with patients of bleeding risks esp. with critical thrombocytopenia, it is important...