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It is therefore important to investigate how hematologists perceive EOL care and how this affects their clinical practice. We assessed a cohort of Italian hematological oncologists through a GIMEMA online survey to explore their attitudes toward standard measures of quality EOL care, their opinions on barriers to providing this care, and potential interventions. EOL quality measures were defined acceptable to hematologist if at least 55% of respondents agreed with their suitability. One-hundred eight-six hematologists completed the survey. Hematologists rated 8 of 13 EOL quality measures as highly acceptable, including no new chemotherapy, no intensive care unit admission, no intubation\/cardiopulmonary resuscitation in the last 30 days of life, and hospice admission\u2009&gt;\u20097 days before death. Major barriers to quality EOL care included unrealistic patient expectations, clinician concerns about taking away hope, and uncertainty about what to say. Moreover, 73% admitted to being unfamiliar with discussing goals of care (GOC) or advance care planning (ACP). Suggested interventions for improvement included increasing the availability and timely integration of palliative care, and access to home care services. In conclusion, Italian hematologists find most standard EOL quality measures acceptable, they identify barriers to quality care, and are open to interventions, including early integration of palliative care, to improve patients\u2019 EOL care. However, they lack familiarity with GOC and ACP discussions, highlighting the need for communication skills training.<\/jats:p>","DOI":"10.1007\/s00277-025-06594-6","type":"journal-article","created":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:58:13Z","timestamp":1760061493000},"page":"5423-5432","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Understanding challenges and barriers to quality end-of-life care for patients with hematologic malignancies: a GIMEMA survey"],"prefix":"10.1007","volume":"104","author":[{"given":"Leonardo","family":"Potenza","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Efficace","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleonora","family":"Borelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Fazi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Baldi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Tartaglia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Sparano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Cartoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Niscola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Mucciarini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oreofe","family":"Odejide","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Bruera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Zimmermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Vignetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Luppi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Bandieri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,10]]},"reference":[{"key":"6594_CR1","doi-asserted-by":"publisher","first-page":"1133","DOI":"10.1200\/JCO.2003.03.059","volume":"21","author":"CC Earle","year":"2003","unstructured":"Earle CC, Park ER, Lai B et al (2003) Identifying potential indicators of the quality of end-of-life cancer care from administrative data. 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ML has participated in advisory boards and meetings with honoraria from AbbVie, Gilead Sciences, Jazz Pharmaceuticals, Novartis, MSD, Grifols, Sanofi, Daiichi-Sankyo, Incyte, Roche, and Istituto Gentili, also unrelated to the submitted work. EBa has served on the advisory board for Sandoz, unrelated to the submitted work. All other authors declared no potential conflicts of interest concerning the research, authorship, and\/or publication of this article.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}