Aging with leukemia: public health strategies for optimizing quality of life and palliative care in refractory cases

Leukemia incidence increases with age, and managing refractory cases in older adults poses unique clinical and public health challenges. Aging patients with leukemia often experience a complex symptom burden exacerbated by comorbidities, frailty, and psychosocial factors that diminish their quality of life (QoL). Traditional curative treatments may become less effective or inappropriate, shifting the focus toward comprehensive supportive care and palliative interventions to alleviate symptoms and enhance well-being. This review examines public health strategies aimed at optimizing QoL and palliative care delivery for older adults with refractory leukemia. Emphasis is placed on multidisciplinary care models that integrate hematology, geriatrics, palliative services, and social support. Addressing social determinants of health, expanding community-based programs, and leveraging telemedicine are highlighted as crucial elements to improve care access, reduce hospitalizations, and support aging patients in their preferred settings. Furthermore, the review identifies key barriers to effective palliative care, including healthcare system fragmentation, provider knowledge gaps, and stigma surrounding palliative services. Policy recommendations focus on workforce education, early palliative care integration, and equitable resource allocation to better meet the needs of this vulnerable population. Ultimately, coordinated public health efforts are essential to enhance the QoL and dignity for aging individuals living with refractory leukemia.