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Determinants of 1-year survival in critically ill acute leukemia patients: a GRRR-OH study

par Tavares, Márcio;Lemiale, Virginie;Mokart, Djamel;Pène, Frédéric;Lengliné, Etienne;Kouatchet, Achille;Mayaux, Julien;Vincent, François;Nyunga, Martine;Bruneel, Fabrice;Rabbat, Antoine;Lebert, Christine;Perez, Pierre;Meert, Anne-Pascale ;Benoit, Dominique;Darmon, Michael;Azoulay, Elie
Référence Leukemia & lymphoma, 59, 6, page (1323-1331)
Publication Publié, 2018-06

Article révisé par les pairs

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Résumé :

Acute leukemia (AL) is the most common hematological malignancy requiring intensive care unit (ICU) management. Data on long-term survival are limited. This is a post hoc analysis of the prospective multicenter data from France and Belgium: A Groupe de Recherche Respiratoire en Réanimation Onco-Hématologique [A Research Group on Acute Respiratory Failure in Onco-Hematological Patients (French)] Study, to identify determinants of 1-year survival in critically ill AL patients. A total of 278 patients were admitted in the 17 participating ICUs. Median age was 58 years and 70% had newly diagnosed leukemia. ICU mortality rate was 28.6 and 39.6% of the patients alive at 1 year. Admission for intensive monitoring was independently associated with better 1-year survival by multivariate analysis. Conversely, relapsed/refractory disease, secondary leukemia, mechanical ventilation and renal replacement therapy were independently associated with 1-year mortality. This study confirms the impact of organ dysfunction on long-term survival in ICU patients with AL. Follow-up studies to assess respiratory and renal recovery are warranted.