Thomas LeBlanc

Overview:

I am a medical oncologist, palliative care physician, and patient experience researcher.  My clinical practice focuses on the care of patients with hematologic malignancies, with a particular emphasis on myeloid conditions and acute leukemias including acute myeloid leukemia (AML), acute lymphocytic leukemia (ALL), myelodysplastic syndromes (MDS), and myeloproliferative neoplasms (MPNs / MPDs, CML).  

As founding Director of the Duke Cancer Patient Experience Research Program (CPEP), my research investigates common issues faced by people with cancer, including issues of symptom burden, quality of life, psychological distress, prognostic understanding, and treatment decision-making. This work aims to improve patients' experiences living with serious illnesses like blood cancers, including the integration of specialist palliative care services to provide an extra layer of support along with their comprehensive cancer care. More broadly, our team in CPEP conducts various studies of patient experience and outcomes issues in oncology, including retrospective chart review studies, comparative effectiveness work, prospective observational studies and registries, and qualitative research, along with efforts to facilitate the integration of patient-generated health data (PGHD) into routine cancer care processes, such as with electronic patient-reported outcome measures (ePROs) and other mobile health interventions (mHealth). 

This work has led to recognition as an "Inspirational Leader under 40" by the American Academy of Hospice and Palliative Medicine (AAHPM), "Fellow" status from the Academy in 2016, the 2018 international "Clinical Impact Award" from the European Association for Palliative Care, and the AAHPM "Early Career Investigator" award in 2020. I served as 2017-18 Chair of the ASCO Ethics Committee, and currently Chair the Scientific Review Committee of the NIH/NINR-funded Palliative Care Research Cooperative Group (PCRC; www.palliativecareresearch.org). I have served on various national guideline panels for AML and for palliative/supportive care issues in oncology, and was inducted as a Fellow of the American Society of Clinical Oncology (FASCO) in 2021. To date I have published over 150 Medline-indexed articles, and several chapters in prominent textbooks of oncology and palliative medicine.

Positions:

Associate Professor of Medicine

Medicine, Hematologic Malignancies and Cellular Therapy
School of Medicine

Associate Professor in Population Health Sciences

Population Health Sciences
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 2006

Duke University

Intern

Duke University School of Medicine

Resident

Duke University School of Medicine

Chief Medical Resident

Duke University School of Medicine

Fellowship, Hospice And Palliative Medicine

Duke University School of Medicine

Fellow, Medical Oncology

Duke University School of Medicine

Grants:

AC220-A-U302 trial

Administered By
Duke Clinical Research Institute
Awarded By
Daiichi Sankyo Inc
Role
Principal Investigator
Start Date
End Date

Prognostic understanding and decision-making in acute myeloid leukemia (AML)

Administered By
Duke Cancer Institute
Awarded By
American Cancer Society, Inc.
Role
Principal Investigator
Start Date
End Date

Randomized Trial of Inpatient Palliative Care for Patients with Hematologic Malignancies

Administered By
Duke Cancer Institute
Awarded By
Massachusetts General Hospital
Role
Principal Investigator
Start Date
End Date

Understanding Barriers to Oral Therapy Adherence in Adult/Older-Adult AML Patients (429 Oral)

Administered By
Duke Cancer Institute
Awarded By
Carevive Systems, Inc.
Role
Principal Investigator
Start Date
End Date

Palliative care and shared decision-making for patients with blood cancers

Administered By
Duke Cancer Institute
Awarded By
Cambia Health Foundation
Role
Principal Investigator
Start Date
End Date

Publications:

Burden of illness and treatment patterns among patients with peripheral T-cell lymphoma in the US healthcare setting.

OBJECTIVE: Limited real-world information exists on the characteristics or treatment patterns of patients with peripheral T-cell lymphoma (PTCL). We reported demographics, treatments and direct healthcare resource utilization (HRU) in a large cohort of US patients newly diagnosed with PTCL. METHODS: Patients aged ≥18 years with a PTCL diagnosis between January 2011 and December 2016 were identified from the Inovalon MORE2 Registry. Continuous medical/pharmacy enrollment 6-months prior to and ≥1-month after the first PTCL diagnosis was required. The main focus of this study was on newly diagnosed patients receiving cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) versus other chemotherapy. RESULTS: A total 2971 patients with PTCL and chemotherapy information were included in the study; 1706 (57%) received CHOP and 1265 (43%) other chemotherapy. A majority of patients (51.7%) were female; mean (standard deviation) age at index was 61.0 (±16.0), Charlson score was 4.1 (±2.9), and follow-up time was 24.6 (±16.7) months. During the variable follow-up period, HRU was similar for the CHOP and other chemotherapy cohorts; 58.1% and 59.3% had ≥1 all-cause hospitalizations, respectively. The proportion of patients with ≥1 PTCL-related hospitalizations was higher in the CHOP than in the other chemotherapy cohort (40.3% vs. 9.7%, respectively) and mean length of stay was longer (4.6 vs. 3.7 days per patient per month, respectively). CONCLUSIONS: This retrospective analysis of patients with PTCL revealed high levels of comorbidity and HRU; novel interventions that improve patient outcomes and reduce the HRU burden of PTCL are needed.
Authors
Petrilla, AA; Shah, A; Feliciano, J; Woolery, J; LeBlanc, TW
MLA Citation
Petrilla, Allison A., et al. “Burden of illness and treatment patterns among patients with peripheral T-cell lymphoma in the US healthcare setting.Curr Med Res Opin, May 2021, pp. 1–9. Pubmed, doi:10.1080/03007995.2021.1920380.
URI
https://scholars.duke.edu/individual/pub1481551
PMID
33944646
Source
pubmed
Published In
Curr Med Res Opin
Published Date
Start Page
1
End Page
9
DOI
10.1080/03007995.2021.1920380

Lean Into the Uncomfortable: Using Trauma-Informed Care to Engage in Shared Decision-Making With Racial Minorities With Hematologic Malignancies.

Discussions involving racial health disparities must include pathways for engaging in shared decision-making with racial/ethnic minorities. Research demonstrates glaring racial and ethnic disparities when it comes to hematologic malignancies from the time of diagnosis to treatment and even at the end of life. Unfortunately, decision-making in these circumstances may be streamlined, given the urgency of the disease, prognostic uncertainty, and varying treatment options. Being diagnosed with cancer is undoubtedly a traumatic experience and a patient's race and/or ethnicity add an important dimension to their experience. The tenets of trauma-informed care (TIC) are anchored in recognizing that trauma can manifest in several ways and acknowledging the impact of past trauma on a patient's present and future behaviors. We argue that using a TIC approach may help hematologists create a space for decision-making while minimizing the risk of re-traumatization and perpetuating racial disparities. Using the foundation of TIC, an interprofessional team can begin addressing manifestations of trauma and hopefully mitigate racial and ethnic disparities.
Authors
Dhawan, N; LeBlanc, TW
MLA Citation
Dhawan, Natasha, and Thomas W. LeBlanc. “Lean Into the Uncomfortable: Using Trauma-Informed Care to Engage in Shared Decision-Making With Racial Minorities With Hematologic Malignancies.Am J Hosp Palliat Care, Apr. 2021, p. 10499091211008432. Pubmed, doi:10.1177/10499091211008431.
URI
https://scholars.duke.edu/individual/pub1481132
PMID
33910380
Source
pubmed
Published In
Am J Hosp Palliat Care
Published Date
Start Page
10499091211008431
DOI
10.1177/10499091211008431

Perceptions of Hematology Among Palliative Care Physicians: Results of a Nationwide Survey.

CONTEXT: Palliative care integration for patients with hematologic diseases has lagged behind solid-organ malignancies. Previous work has characterized hematologist perspectives, but less is known about palliative care physician views of this phenomenon. OBJECTIVES: To examine palliative care physician attitudes and beliefs regarding hematologic diseases, patient care, and collaboration. METHODS: A 44-item survey containing Likert and free-response items was mailed to 1,000 AAHPM physician members. Sections explored respondent comfort with specific diagnoses, palliative care integration, relationships with hematologists, and hematology-specific patient care. Logistic regression models with generalized estimating equations were used to compare parallel Likert responses. Free responses were analyzed using thematic analysis. RESULTS: The response rate was 55.5%. Respondents reported comfort managing symptoms in leukemia (84.0%), lymphoma (92.1%), multiple myeloma (92.9%), and following hematopoietic stem cell transplant (51.6%). Fewer expressed comfort with understanding disease trajectory (64.9%, 75.7%, 78.5%, and 35.4%) and discussing prognosis (71.0%, 82.6%, 81.6%, and 40.6%). 97.6% of respondents disagreed that palliative care and hematology are incompatible. 50.6% felt that palliative care physicians' limited hematology-specific knowledge hinders collaboration. 89.4% felt that relapse should trigger referral. 80.0% felt that hospice referrals occurred late. In exploring perceptions of hematology-palliative care relationships, three themes were identified: misperceptions of palliative care, desire for integration, and lacking a shared model of understanding. CONCLUSION: These data inform efforts to integrate palliative care into hematologic care at large, echoing previous studies of hematologist perspectives. Palliative care physicians express enthusiasm for caring for these patients, desire for improved understanding of palliative care, and ongoing opportunities to improve hematology-specific knowledge and skills.
Authors
Santivasi, WL; Childs, DS; Wu, KM; Partain, DK; Litzow, MR; LeBlanc, TW; Strand, JJ
MLA Citation
Santivasi, Wil L., et al. “Perceptions of Hematology Among Palliative Care Physicians: Results of a Nationwide Survey.J Pain Symptom Manage, Apr. 2021. Pubmed, doi:10.1016/j.jpainsymman.2021.04.021.
URI
https://scholars.duke.edu/individual/pub1481473
PMID
33933620
Source
pubmed
Published In
J Pain Symptom Manage
Published Date
DOI
10.1016/j.jpainsymman.2021.04.021

Integrated Palliative and Oncology Care for Patients With Acute Myeloid Leukemia-Moving From Evidence to Practice-Reply.

Authors
El-Jawahri, A; LeBlanc, TW; Temel, JS
MLA Citation
El-Jawahri, Areej, et al. “Integrated Palliative and Oncology Care for Patients With Acute Myeloid Leukemia-Moving From Evidence to Practice-Reply.Jama Oncol, Apr. 2021. Pubmed, doi:10.1001/jamaoncol.2021.0709.
URI
https://scholars.duke.edu/individual/pub1479077
PMID
33885719
Source
pubmed
Published In
Jama Oncol
Published Date
DOI
10.1001/jamaoncol.2021.0709

Systematic review of decision aids in hematologic malignancies

Authors
Zhao, J; Abdallah, M; Sanapala, C; Watson, E; Xie, Z; Castillo, D; Richardson, D; LeBlanc, TW; Mohile, S; Loh, K
MLA Citation
Zhao, J., et al. “Systematic review of decision aids in hematologic malignancies.” Journal of the American Geriatrics Society, vol. 69, 2021, pp. S292–S292.
URI
https://scholars.duke.edu/individual/pub1479078
Source
wos-lite
Published In
Journal of the American Geriatrics Society
Volume
69
Published Date
Start Page
S292
End Page
S292

Research Areas:

Aged
Attitude of Health Personnel
Attitude to Death
Attitude to Health
Cardiovascular Diseases
Clinical Competence
Clinical Trials as Topic
Cognition Disorders
Communication
Comparative Effectiveness Research
Decision Making
Diffusion of Innovation
Dyspnea
Ethics
Evidence-Based Medicine
Guideline Adherence
Health Services Research
Hematologic Neoplasms
Hospice Care
Information Dissemination
Inpatients
Jargon
Leukemia
Lung Neoplasms
Lymphoma
Medical education
Myelodysplastic Syndromes
Myeloproliferative Disorders
Neoplasms
Nonverbal Communication
Odds Ratio
Oncology Service, Hospital
Outcome Assessment (Health Care)
Oxygen
Pain
Pain Management
Palliative Care
Patient Selection
Patient-Centered Care
Perception
Prognosis
Quality of Health Care
Statistics as Topic
Terminal Care
Treatment Outcome
Withholding Treatment