The term haematological malignancy refers to a collection of heterogeneous neoplasms with significant variation in presentation, prognosis and management. Survival is vastly different between people with early-stage Hodgkin lymphoma versus elderly people diagnosed with acute myeloid leukaemia. Even within a specific disease type, substantial variation exists in treatment and prognosis that is dependent on characteristics of the individual (i.e. age, comorbidities) and the disease (i.e. cytogenetics, method of development).

For many people with a haematological malignancy, aggressive treatment provides the only possible hope of cure, but also carries the risk of serious complications and death. Patients who receive conservative supportive therapy are also at risk of deterioration due to bone marrow suppression. People with a haematological malignancy often experience episodes of sudden and acute deterioration related to the treatment or the underlying disease.1,2 However, it is not uncommon for these patients to recover from episodes of ‘near-to-death’ deterioration.1,2 This erratic illness trajectory makes predicting survival near the end of life difficult for clinicians.2 Hence, people with a haematological malignancy often experience a swift change in their goals of care, leaving little time for planning and preparing for death.1,2