Haematological malignancy in the intensive care unit: microbiology results and mortality

Beers, Eduard J. van; Müller, M. C. A.; Vlaar, Alexander P.J.; Spanjaard, Lodewijk; Bergh, Walter M. van den

doi:10.1111/ejh.12721

Cited by 7 publications

(7 citation statements)

References 33 publications

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“…These results are consistent with other published data. 24,25 Beers et al 26 also found that neutropenia on its own was not a risk factor for adverse outcomes during the ICU stay. In combination with a positive blood culture, neutropenia was an independent risk factor for 28-day mortality.…”

Section: Discussionmentioning

confidence: 97%

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Outcomes after intensive care unit admission in newly diagnosed diffuse large B‐cell lymphoma patients: A real‐life study

Zduniak

Mihailescu

Lequesne

et al. 2021

European J of Haematology

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We conducted a retrospective study to analyze the prognostic factors impacting the overall survival (OS) and progression‐free survival (PFS) of diffuse large B‐cell lymphoma (DLBCL) patients undergoing first‐line therapy and admitted to intensive care unit (ICU) compared to a control cohort who did not required ICU admission. Between January 1, 2008, and December 31, 2018, 828 patients were diagnosed with DLBCL at our institution, including 72 patients who were required ICU admission during disease course. Among them, forty‐five patients undergoing homogeneous first‐line therapy with /R‐CHOP‐like regimen and ICU‐admitted were selected for the present analysis. Control “non‐ICU” DLBCL patients were matched by age, IPI score and treatment received. The median age at ICU admission was 65 years, 97.8% of patients displayed advanced‐stage disease (III/IV), and 84.4% had a high IPI score (3‐5). The main reasons for ICU admission were acute respiratory failure (40.0%) and septic shock (33.3%). The ICU mortality rate was 33.3%. The 2‐year PFS was lower in ICU survivors patients than in non‐ICU patients: 31.7% (95% CI 18.5‐54.1) vs 60.8% (95% CI 51.2‐72.1, P = .00049). Admission to the ICU is an event that clearly impacts the outcomes of patients with DLBCL, until 2 years after the event. ICU prognosis seems mainly related to critical patient severity at admission rather than lymphoma‐related prognostic factors (IPIs), suggesting that ICU admission criteria should not be based only on the lymphoma prognosis.

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Section: Discussionmentioning

confidence: 97%

“…At day 1 28 [24][25][26][27][28][29][30][31][32] 27 [24][25][26][27][28][29][30][31][32] 28.7 ± 5.8 27.9 ± 6.…”

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Outcomes after intensive care unit admission in newly diagnosed diffuse large B‐cell lymphoma patients: A real‐life study

Zduniak

Mihailescu

Lequesne

et al. 2021

European J of Haematology

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“…Our findings are in line with recent studies reporting on mortality of neutropenic patients admitted to the ICU. These studies failed to demonstrate an association of neutropenia with increased mortality [18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Predictors of short-term and long-term mortality in critically ill patients admitted to the intensive care unit following allogeneic stem cell transplantation

Heiden

Arbous

Beers

et al. 2018

Bone Marrow Transplant

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Historically, the mortality of patients admitted to the ICU after allogeneic stem cell transplantation (alloSCT) is high. Advancements in transplantation procedures, infectious monitoring and supportive care may have improved the outcome. This study aimed to determine short-term and long-term mortality after ICU admission of patients after alloSCT and to identify prognostic clinical and transplantation-related determinants present at ICU admission for long-term outcome. A multicenter cohort study was performed to determine 30-day and 1-year mortality within 2 years following alloSCT. A total of 251 patients were included. The 30-day and 1-year mortality was 55% and 80%, respectively. Platelet count <25 × 10/L (OR: 2.26, CI: 1.02-5.01) and serum bilirubin >19 μmol/L (OR: 2.47 CI: 1.08-5.65) at admission, other donor than a HLA-matched-related or HLA-matched-unrelated donor (OR: 4.59, CI: 1.49-14.1) and vasoactive medication within 24 h (OR: 2.35, CI: 1.28-4.31) were associated with increased 30-day mortality. Other donor than a HLA-matched-related or HLA-matched-unrelated donor (OR: 1.9, CI: 1.13-3.19), serum bilirubin >77 (OR: 2.05, CI: 1.28-3.30) and vasoactive medication within 24 h (OR: 1.65, CI: 1.12-2.43) were associated with increased 1-year mortality. Neutropenia was associated with decreased 30-day and 1-year mortality (OR: 0.29, CI: 0.14-0.59 and OR: 0.70, CI: 0.48-0.98). Myeloablative conditioning and T cell-depleted transplantation were not associated with increased mortality.

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“…Up to 15% of patients with a haematological malignancy require admission to an Intensive Care Unit (ICU) in the early phases of their disease (Schellongowski et al , ; Bird et al , ; Azoulay et al , ; van Beers et al , ). These patients are immunocompromised due to disease‐ and therapy‐related bone marrow dysfunction and immunosuppressive treatment, and are therefore at risk for infections.…”

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confidence: 99%

Time trend analysis of long term outcome of patients with haematological malignancies admitted at dutch intensive care units

et al. 2018

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A few decades ago, the chances of survival for patients with a haematological malignancy needing Intensive Care Unit (ICU) support were minimal. As a consequence, ICU admission policy was cautious. We hypothesized that the long-term outcome of patients with a haematological malignancy admitted to the ICU has improved in recent years. Furthermore, our objective was to evaluate the predictive value of the Acute Physiology and Chronic Health Evaluation (APACHE) II score. A total of 1095 patients from 5 Dutch university hospitals were included from 2003 until 2015. We studied the prevalence of patients' characteristics over time. By using annual odds ratios, we analysed which patients' characteristics could have had influenced possible trends in time. A approximated mortality rate was compared with the ICU mortality rate, to study the predictive value of the APACHE II score. Overall one-year mortality was 62%. The annual decrease in one-year mortality was 7%, whereas the APACHE II score increased over time. Decreased mortality rates were particularly observed in high-risk patients (acute myeloid leukaemia, old age, low platelet count, bleeding as admission reason and need for mechanical ventilation within 24 h of ICU admission). Furthermore, the APACHE II score overestimates mortality in this patient category.

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Haematological malignancy in the intensive care unit: microbiology results and mortality

Cited by 7 publications

References 33 publications

Outcomes after intensive care unit admission in newly diagnosed diffuse large B‐cell lymphoma patients: A real‐life study

Outcomes after intensive care unit admission in newly diagnosed diffuse large B‐cell lymphoma patients: A real‐life study

Predictors of short-term and long-term mortality in critically ill patients admitted to the intensive care unit following allogeneic stem cell transplantation

Time trend analysis of long term outcome of patients with haematological malignancies admitted at dutch intensive care units

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