BACKGROUND: Predictors of outcome and rates of successful discharge have not been defined for patients with acute leukemia admitted to intensive care units (ICUs) in the US. METHODS: This is a retrospective analysis of 90 patients with acute leukemia (no history of bone marrow transplant) admitted to an ICU from 2001-2004. The primary endpoints were improvement and subsequent discharge from the ICU, discharge from the hospital, and 2-month survival after hospital discharge. Secondary endpoints were 6- and 12-month survival. Univariate and multivariate logistic regression analyses were performed to identify factors predicting outcome. RESULTS: The median age of patients was 54 years and 48 (53%) were male. The most common reason for ICU transfer for all patients was respiratory compromise. The majority of all patients (68%) were eventually placed on ventilator support and approximately half required pressors. During the ICU course, 29 patients (32%) improved and subsequently resumed aggressive leukemia management, and 24 patients (27%) survived to be discharged from the hospital. The 2-, 6-, and 12-month overall survival was 24 (27%), 16 (18%), and 14 (16%), respectively. Higher APACHE II score, use of pressors, undergoing bone marrow transplantation preparative regimen, and adverse cytogenetics predicted worse outcome. Newly diagnosed leukemia, type of leukemia, or age did not. CONCLUSIONS: One of 4 patients with acute leukemia survived an ICU admission to be discharged from the hospital and were alive 2 months later. A diagnosis of acute leukemia should not disqualify patients from an ICU admission. (c) 2008 American Cancer Society.
BACKGROUND: Predictors of outcome and rates of successful discharge have not been defined for patients with acute leukemia admitted to intensive care units (ICUs) in the US. METHODS: This is a retrospective analysis of 90 patients with acute leukemia (no history of bone marrow transplant) admitted to an ICU from 2001-2004. The primary endpoints were improvement and subsequent discharge from the ICU, discharge from the hospital, and 2-month survival after hospital discharge. Secondary endpoints were 6- and 12-month survival. Univariate and multivariate logistic regression analyses were performed to identify factors predicting outcome. RESULTS: The median age of patients was 54 years and 48 (53%) were male. The most common reason for ICU transfer for all patients was respiratory compromise. The majority of all patients (68%) were eventually placed on ventilator support and approximately half required pressors. During the ICU course, 29 patients (32%) improved and subsequently resumed aggressive leukemia management, and 24 patients (27%) survived to be discharged from the hospital. The 2-, 6-, and 12-month overall survival was 24 (27%), 16 (18%), and 14 (16%), respectively. Higher APACHE II score, use of pressors, undergoing bone marrow transplantation preparative regimen, and adverse cytogenetics predicted worse outcome. Newly diagnosed leukemia, type of leukemia, or age did not. CONCLUSIONS: One of 4 patients with acute leukemia survived an ICU admission to be discharged from the hospital and were alive 2 months later. A diagnosis of acute leukemia should not disqualify patients from an ICU admission. (c) 2008 American Cancer Society.
Authors: Aliénor Xhaard; Loic Epelboin; David Schnell; François Vincent; Vincent Levy; Marion Malphettes; Elie Azoulay; Michaël Darmon Journal: Support Care Cancer Date: 2013-02-15 Impact factor: 3.603
Authors: Mikkael A Sekeres; Paul Elson; Matt E Kalaycio; Anjali S Advani; Edward A Copelan; Stefan Faderl; Hagop M Kantarjian; Elihu Estey Journal: Blood Date: 2008-09-30 Impact factor: 22.113
Authors: Tamjeed Ahmed; Abby L Koch; Scott Isom; Heidi D Klepin; Jonathan M Bishop; Leslie R Ellis; Dmitriy Berenzon; Dianna Howard; Susan Lyerly; Bayard L Powell; Timothy S Pardee Journal: Leuk Res Date: 2017-09-27 Impact factor: 3.156
Authors: Alan P Kraguljac; Danielle Croucher; Michael Christian; Narmin Ibrahimova; Vikram Kumar; Gabriella Jacob; Alex Kiss; Mark D Minden; Sangeeta Mehta Journal: Can Respir J Date: 2016-06-30 Impact factor: 2.409