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Pfeffer MA, Martens K, Kartika T, McMurry H, Olson S, DeLoughery T, Shatzel JJ. Psychological toxicity in classical hematology. Eur J Haematol 2023; 111:516-527. [PMID: 37455616 PMCID: PMC10530171 DOI: 10.1111/ejh.14038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/27/2023] [Accepted: 06/29/2023] [Indexed: 07/18/2023]
Abstract
Although considered "benign," mild blood count abnormalities, genetic factors imparting inconsequential thrombotic risk, and low-risk premalignant blood disorders can have significant psychological and financial impact on our patients. Several studies have demonstrated that patients with noncancerous conditions have increased levels of anxiety with distress similar to those with malignancy. Additionally, referral to a classical hematologist can be a daunting process for many patients due to uncertainties surrounding the reason for referral or misconstrued beliefs in a cancer diagnosis ascribed to the pairing of oncology and hematology in medical practice. If not properly triaged, incidental laboratory abnormalities can trigger extensive and costly evaluation. These challenges are compounded by a lack of consensus guidance and generalizability of modern reference ranges that do not adequately account for common influencing factors. Although often benign, incidental hematologic findings can lead to emotional suffering and careful consideration of the potential psychological and financial duress imparted to an individual must be considered. In this article, we will review the current literature describing the psychological effect of some commonly known hematologic conditions, identify benign causes for variations in hematologic laboratory values, and provide recommendations to reduce psychological toxicity as it pertains to hematologic testing.
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Affiliation(s)
- Michael A Pfeffer
- Division of Hematology and Medical Oncology, School of Medicine, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Kylee Martens
- Division of Hematology and Medical Oncology, School of Medicine, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Thomas Kartika
- Division of Hematology and Medical Oncology, School of Medicine, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Hannah McMurry
- Division of Hematology and Medical Oncology, School of Medicine, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Sven Olson
- Division of Hematology and Medical Oncology, School of Medicine, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Thomas DeLoughery
- Division of Hematology and Medical Oncology, School of Medicine, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Joseph J Shatzel
- Division of Hematology and Medical Oncology, School of Medicine, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon, USA
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Sgherza N, Curci P, Rizzi R, Strafella V, Di Gennaro D, Vitucci A, Palma A, Rossi AVR, Albano F, Stefanizzi P, Tafuri S, Musto P. Incidence and outcome of SARS-CoV-2 infection in patients with monoclonal gammopathy of undetermined significance: a case-control study. Haematologica 2021; 107:555-557. [PMID: 34732044 PMCID: PMC8804555 DOI: 10.3324/haematol.2021.279895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Indexed: 11/21/2022] Open
Affiliation(s)
- Nicola Sgherza
- Hematology and Bone Marrow Transplantation Unit, AOUC Policlinico, Bari
| | - Paola Curci
- Hematology and Bone Marrow Transplantation Unit, AOUC Policlinico, Bari
| | - Rita Rizzi
- Hematology and Bone Marrow Transplantation Unit, AOUC Policlinico, Bari, Italy; Department of Emergency and Organ Transplantation, "Aldo Moro" University School of Medicine, Bari
| | - Vanda Strafella
- Department of Emergency and Organ Transplantation, "Aldo Moro" University School of Medicine, Bari
| | - Daniela Di Gennaro
- Department of Emergency and Organ Transplantation, "Aldo Moro" University School of Medicine, Bari
| | | | - Antonio Palma
- Hematology and Bone Marrow Transplantation Unit, AOUC Policlinico, Bari
| | | | - Francesco Albano
- Department of Emergency and Organ Transplantation, "Aldo Moro" University School of Medicine, Bari
| | - Pasquale Stefanizzi
- Department of Biomedical Science and Human Oncology, "Aldo Moro" University School of Medicine, Bari
| | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, "Aldo Moro" University School of Medicine, Bari
| | - Pellegrino Musto
- Hematology and Bone Marrow Transplantation Unit, AOUC Policlinico, Bari, Italy; Department of Emergency and Organ Transplantation, "Aldo Moro" University School of Medicine, Bari.
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