Ashby Michael, Fleming Shaun, Spencer Andrew, Woollett Anne, Wright Tricia
Department of Cancer Services, Latrobe Regional Health, Traralgon, Victoria, Australia.
Department of Clinical Haematology, Alfred Health, Melbourne, Victoria, Australia.
Intern Med J. 2025 May;55(5):722-727. doi: 10.1111/imj.70011. Epub 2025 Mar 8.
The management of patients with haematological malignancies in rural and regional Australia is different to that in metropolitan centres due to many factors. Lower-intensity and easier-to-access treatments that are now available for acute myeloid leukaemia (AML) and myelodysplastic syndrome (MDS) have improved the deliverability of treatment options for these disorders. Despite the challenges, urgent work is required to allow the care and outcomes of these patients to mirror those living in metropolitan centres.
To highlight the challenges in management of AML and MDS in regional Victoria.
Four clinical cases describing the difficulties faced in the management of AML/MDS patients in regional Victoria.
We describe limitations in inpatient services, supportive care, blood product access and both specialised diagnostics and specialist workforce. Access to clinical trials is limited but vital to allow the availability of all therapeutic options.
Limitations in management of AML/MDS patients exist in regional centres. We utilised focused clinical fellows in a partnership between Latrobe Regional Health and Alfred Health in Victoria to improve treatment options for these patients. Moreover, we demonstrate future areas of focus, which will further enable rural and regional healthcare providers to bridge the gap in the care of patients with haematological malignancies.
由于多种因素,澳大利亚农村和地区血液系统恶性肿瘤患者的管理与大城市中心不同。目前可用于急性髓系白血病(AML)和骨髓增生异常综合征(MDS)的强度较低且更容易获得的治疗方法,改善了这些疾病治疗方案的可及性。尽管存在挑战,但仍需要开展紧急工作,以使这些患者的护理和治疗结果与大城市中心的患者相当。
强调维多利亚州地区AML和MDS管理中的挑战。
四个临床病例描述了维多利亚州地区AML/MDS患者管理中面临的困难。
我们描述了住院服务、支持性护理、血液制品获取以及专业诊断和专业人员方面的限制。临床试验的可及性有限,但对于所有治疗方案的可用性至关重要。
地区中心在AML/MDS患者管理方面存在限制。我们在维多利亚州拉特罗布地区卫生服务中心和阿尔弗雷德卫生服务中心的合作中利用了专注的临床研究员,以改善这些患者的治疗选择。此外,我们展示了未来的重点领域,这将进一步使农村和地区医疗服务提供者缩小血液系统恶性肿瘤患者护理方面的差距。