A SYSTEMATIC REVIEW OF PAIN ASSESSMENT IN PATIENTS WITH HEMATOLOGICAL MALIGNANCY

Introduction: Pain presents in adult patients with hematological malignancies (HM), due to the disease itself and to the side effects of treatments. However, it is neither timely or properly assessed, so it goes by underdiagnosed and undertreated, thus affecting patients’ quality of life (QoL).

Aim: To investigate the assessment of pain in patients with HM.

Methods: A systematic review was carried out in the PubMed database, with the following terms in English for the years 2012 to 2022: pain, hematologic malignancies, assessment, multiple myeloma, lymphoma, leukemia, hematopoietic stem cell transplantation.

Results: Thirty-seven studies were included in the review. They present large heterogeneity in terms of the research questions, study population, study design and outcomes. Sixteen studies included pain assessment in patients who underwent hematopoietic stem cell transplantation, twenty included multiple myeloma patients and the rest of the studies had a sample of mixed populations with HM. Five studies were found that included pain assessment and management before and after interventions of acupuncture, music therapy, feet massage and usage of special mouthwash for oral mycositis. The pain induced from peripheral neuropathy was reported in two studies and the one from oral mycositis in four studies. Twenty-six studies, assessed QoL with measurement instruments that included an item on pain. They also present heterogeneity regarding measurement tools, since others use a specific pain tool and others a tool for QoL or functionality.

Conclusions: The common theme that emerged is that pain is a frequent symptom that affects patient’s QoL in all aspects (physical, emotional, social) in varying degrees. The systematic assessment of pain by healthcare professionals, using appropriate measurement tools will contribute to a better understanding of patients' pain experience and consequently to its proper management, However, with weaknesses and shortcomings in the revised studies’ methodology results are difficult to generalize.