Outcome of patients with newly diagnosed AML admitted to the ICU, including preemptive admission - a multi-center study.

Acute myeloid leukemia Early pre-emptive admission Hyperleukocytosis Induction chemotherapy Intensive care unit

Journal

Annals of hematology
ISSN: 1432-0584
Titre abrégé: Ann Hematol
Pays: Germany
ID NLM: 9107334

Informations de publication

Date de publication:
Jun 2023
Historique:
received: 25 10 2022
accepted: 29 03 2023
medline: 15 5 2023
pubmed: 12 4 2023
entrez: 11 4 2023
Statut: ppublish

Résumé

Acute myeloid leukemia (AML) can lead to life-threatening complications that may require intensive care unit (ICU) management. It has been advocated that early preemptive (ePE) ICU admission, before the onset of organ failure, could benefit some high-risk patients such as those with hyperleukocytosis. The aim of this study was to retrospectively analyze the outcome of newly diagnosed AML patients who required ICU admission in five academic centers with a special focus on patients with an ePE admission strategy, i.e., those transferred to the ICU without any organ failure (modified SOFA score ≤ 2 [omitting thrombocytopenia] and no life-sustaining intervention in the first 24 h following ICU admission) before the start of induction therapy. Between January 2017 and December 2019, 428 patients were included among which 101 were admitted to the ICU. Among patients requiring life-sustaining interventions (n = 83), 18 (22%) died while in the ICU but ICU survivors had the same survival as those not admitted to the ICU. Patients with an ePE admission (n = 18) had more comorbidities and high-risk disease features such as hyperleukocytosis but required no life-sustaining interventions while in the ICU. In a subgroup analysis of patients with hyperleukocytosis ≥ 50 G/l at diagnosis (n = 85), patients not admitted to the ICU and those admitted with an ePE strategy had similar outcomes. This study provides encouraging results about ICU outcome in AML patients during induction therapy but the potential benefit of an ePE strategy must be confirmed prospectively.

Identifiants

pubmed: 37039874
doi: 10.1007/s00277-023-05205-6
pii: 10.1007/s00277-023-05205-6
doi:

Types de publication

Multicenter Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1383-1393

Informations de copyright

© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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Auteurs

Christophe Desprez (C)

Service des maladies du sang, CHU d'Angers, 4 rue LarreyAngers Cedex 9, F-49933, Angers, France.
Service de médecine intensive et réanimation et de médecine hyperbare, CHU d'Angers, Angers, France.

Achille Kouatchet (A)

Service de médecine intensive et réanimation et de médecine hyperbare, CHU d'Angers, Angers, France.

Tony Marchand (T)

Service d'hématologie clinique, CHU de Rennes, Rennes, France.
INSERM U1236, Université Rennes 1, Rennes, France.
Federation hospitalo-universitaire « Grand Ouest against Leukemia », Nantes, France.

Jean Baptiste Mear (JB)

Service d'hématologie clinique, CHU de Rennes, Rennes, France.

Jean Marc Tadié (JM)

Maladies Infectieuses et Réanimation Médicale, CHU Rennes, Rennes, France.

Pierre Peterlin (P)

Federation hospitalo-universitaire « Grand Ouest against Leukemia », Nantes, France.
Service d'hématologie clinique, CHU de Nantes, Nantes, France.

Patrice Chevalier (P)

Federation hospitalo-universitaire « Grand Ouest against Leukemia », Nantes, France.
Service d'hématologie clinique, CHU de Nantes, Nantes, France.

Emmanuel Canet (E)

Intensive Care Unit, CHU de Nantes, Nantes, France.

Marie-Anne Couturier (MA)

Federation hospitalo-universitaire « Grand Ouest against Leukemia », Nantes, France.
Service d'Hématologie Clinique, Hôpital Morvan, CHU de Brest, Brest, France.

Gaelle Guillerm (G)

Federation hospitalo-universitaire « Grand Ouest against Leukemia », Nantes, France.
Service d'Hématologie Clinique, Hôpital Morvan, CHU de Brest, Brest, France.

Laetitia Bodenes (L)

Médecine Intensive et Réanimation, CHU de Brest, Hôpital de la Cavale Blanche, Brest, France.

Emmanuel Gyan (E)

Federation hospitalo-universitaire « Grand Ouest against Leukemia », Nantes, France.
Service d'Hématologie et Thérapie Cellulaire, CHRU de Tours, Hôpital Bretonneau, Tours, France.

Alban Villate (A)

Federation hospitalo-universitaire « Grand Ouest against Leukemia », Nantes, France.
Service d'Hématologie et Thérapie Cellulaire, CHRU de Tours, Hôpital Bretonneau, Tours, France.

Stephan Ehrmann (S)

Service de Médecine Intensive et Réanimation, CHRU de Tours, Hôpital Bretonneau, Tours, France.

Anne Lebreton (A)

Pharmacie, CHU d'Angers, Angers, France.

Marie-Antoinette Lester (MA)

Pharmacie, CHU de Rennes, Rennes, France.

Clémentine Fronteau (C)

Pharmacie, Nantes Université, CHU Nantes, F-44000, Nantes, France.

Gaelle Larhantec (G)

Pharmacie Oncologique, CHU de Brest, Hôpital Morvan, Brest, France.

Virginie André (V)

Phamarcie, CHRU de Tours, Tours, France.

Jérémie Riou (J)

Inserm, CNRS, MINT, SFR ICAT, Univ Angers, CHU Angers, Angers, France.

Mathilde Hunault-Berger (M)

Service des maladies du sang, CHU d'Angers, 4 rue LarreyAngers Cedex 9, F-49933, Angers, France.
Federation hospitalo-universitaire « Grand Ouest against Leukemia », Nantes, France.
Inserm UMR 1307, CNRS UMR 6075, Nantes Université, CRCI2NA, Université d'Angers, F-49000, Angers, France.

Aline Schmidt-Tanguy (A)

Service des maladies du sang, CHU d'Angers, 4 rue LarreyAngers Cedex 9, F-49933, Angers, France.
Federation hospitalo-universitaire « Grand Ouest against Leukemia », Nantes, France.
Inserm UMR 1307, CNRS UMR 6075, Nantes Université, CRCI2NA, Université d'Angers, F-49000, Angers, France.

Corentin Orvain (C)

Service des maladies du sang, CHU d'Angers, 4 rue LarreyAngers Cedex 9, F-49933, Angers, France. corentin.orvain@chu-angers.fr.
Federation hospitalo-universitaire « Grand Ouest against Leukemia », Nantes, France. corentin.orvain@chu-angers.fr.
Inserm UMR 1307, CNRS UMR 6075, Nantes Université, CRCI2NA, Université d'Angers, F-49000, Angers, France. corentin.orvain@chu-angers.fr.

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