Cassidy Luke, Shand Antonia, Said Joanne M, Hobbs Kim, Kidson-Gerber Giselle, Belinda Campbell, Cutts Briony, Heath Susan, Anazodo Antoinette, King Kylie, Palfreyman Emma, Di Ciaccio Pietro, Mills Georgia, Tang Catherine, Gangatharan Shane, Johnston Anna, Morris Kirk, Hamad Nada
Department of Haematology and Bone Marrow Transplant, St Vincent's Hospital, Darlinghurst, NSW, Australia.
School of Medicine, The University of Notre Dame Sydney, Darlinghurst, NSW, Australia.
Intern Med J. 2025 Mar;55(3):393-406. doi: 10.1111/imj.16651. Epub 2025 Mar 5.
Haematological malignancies diagnosed during pregnancy are rare, with increasing incidence, presenting unique therapeutic, social and ethical challenges for treating teams, patients and their family. There are no national guidelines regarding appropriate referral pathways, resources and services for the management of these patients.
To conduct a systematic review of the literature to identify the multidisciplinary team members required for optimal care of pregnant patients with haematological malignancies. These data will be used to evaluate the capabilities of Australian health networks to provide coordinated care.
A systematic review of the literature in MEDLINE and SCOPUS databases was conducted. Eligible studies focused on pregnant Australian patients with haematological malignancies, exploring care models, specialist teams and services utilised. This was then used to generate a map of Australian hospitals that can service this patient demographic.
Essential team members include haematologists, maternal-fetal medicine specialists, anaesthetists, midwives, intensive care specialists, psychologists and social workers. Services utilised include haematology, maternity, intensive care, tertiary imaging, operating theatre, pharmacy and perinatal mental health services. Utilising these data, 25 hospitals can manage these patients.
This study identified the necessary healthcare practitioners, services and hospitals available that can manage this patient cohort. Future research should focus on determining ideal treatment regimens, timing of therapy throughout gestation, establishing a national patient registry and implementing a cancer care plan and frameworks for best practice care. A centralised referral pathway leveraging telehealth will allow expedient, multidisciplinary action and equity in access to all women across Australia.
孕期诊断出的血液系统恶性肿瘤较为罕见，但发病率呈上升趋势，给治疗团队、患者及其家属带来了独特的治疗、社会和伦理挑战。目前尚无关于这些患者管理的适当转诊途径、资源和服务的国家指南。
对文献进行系统综述，以确定为孕期血液系统恶性肿瘤患者提供最佳护理所需的多学科团队成员。这些数据将用于评估澳大利亚卫生网络提供协调护理的能力。
对MEDLINE和SCOPUS数据库中的文献进行系统综述。符合条件的研究聚焦于澳大利亚孕期血液系统恶性肿瘤患者，探讨护理模式、所使用的专科团队和服务。然后据此绘制出能够为这一患者群体提供服务的澳大利亚医院地图。
核心团队成员包括血液科医生、母胎医学专家、麻醉师、助产士、重症监护专家、心理学家和社会工作者。所使用的服务包括血液科、产科、重症监护、三级影像、手术室、药房和围产期心理健康服务。利用这些数据，25家医院可以管理这些患者。
本研究确定了能够管理这一患者群体的必要医疗从业者、服务和医院。未来的研究应侧重于确定理想的治疗方案、整个孕期的治疗时机、建立全国患者登记册以及实施癌症护理计划和最佳实践护理框架。利用远程医疗的集中转诊途径将使澳大利亚各地所有女性能够迅速获得多学科行动和平等的医疗服务。
