Improved survival rates of AML patients following admission to the intensive care unit

Leuk Lymphoma. 2019 Oct;60(10):2423-2431. doi: 10.1080/10428194.2019.1594213. Epub 2019 Apr 3.

Abstract

Induction chemotherapy in AML patients may have life-threatening side effects requiring intensive care unit (ICU) treatment. We analyzed all AML patients receiving intensive chemotherapy at a single academic center between 01/2006-12/2016. At least one ICU admission was observed in 32% (76/240) patients, and 33% of those died following ICU admission. Whereas the ICU admission proportion remained stable, mortality after ICU admission decreased from 14% (2006-2008) to 3% (2014-2016; p = .056). The number of failing organ systems inversely correlated with surviving ICU admission (p < .001). Sepsis and renal, cardiac and pulmonary failure were each associated with higher mortality. With increasing ICU duration, survival probability decreased (p < .001), but remained >50% even after 14 days of ICU treatment. Progression-free and overall survival were comparable between ICU surviving patients and patients never needing ICU support. In conclusion, outcome after ICU admission of AML patients has substantially improved in recent years.

Keywords: AML; ICU; intensive care; intensive treatment; outcome; prognosis; survival.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Critical Care*
  • Female
  • Hospital Mortality
  • Humans
  • Intensive Care Units*
  • Kaplan-Meier Estimate
  • Length of Stay
  • Leukemia, Myeloid, Acute / epidemiology
  • Leukemia, Myeloid, Acute / mortality*
  • Male
  • Middle Aged
  • Patient Admission*
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors