Filling the gaps to empower regional centres to manage myelodysplastic syndrome and acute myeloid leukaemia leading to wider cancer healthcare delivery and access to clinical trials

Abstract

Background: 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. Aims: To highlight the challenges in management of AML and MDS in regional Victoria. Methods: Four clinical cases describing the difficulties faced in the management of AML/MDS patients in regional Victoria. Results: 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. Conclusions: 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.