Supplementary Table: Summary of clinical studies evaluating clinical outcomes in critically ill patients with hematologic malignancies.
Study
Schuster et
al[1]
Estopa et al[2]
Year
1983
Design
Retrospective
N
77
Population
HM
Control Group
No
Outcomes
MR: ICU 60%; Hospital 80%
Prognostic factors
Hospital mortality1 – ICU LOS>2 wks, MV>5 d
1984
Retrospective
30
Peters et al[3]
1988
Retrospective
119
HM + respiratory
failure
HM + MV
No
MR: ICU 80%; Hospital 93%; 2-yr 97%
Not evaluated
No
MR: Hospital 82%
Median survival from hosp discharge 1-yr
MR: Hospital 69% (ICU) vs. 16% (ward)
ICU LOS: Survivors 3.2 d vs. dead 9.4 d
MR: Hospital 69%
Hospital mortality1 – acute leukemia, NHL
Johnson et
al[4]
Ashkenazi et
al[5]
1986
Retrospective
26
HM
1986
Retrospective
29
Lloyd-Thomas
et al[6]
1986
Retrospective
22
Acute leukemia
(n=21)/acute
lymphoma (n=8)
HM
Unmatched
(HM ward, n=120)
No
No
MR: ICU 55% ; Hospital 82%
HM
No
MR: ICU 63%; Hospital 78%
260
HM
No
MR: ICU 43%; Hospital 57%
Retrospective
92
HM
No
1995
Retrospective
32
AML/BMT + MV
Unmatched
MR: ICU 65%; Hospital 77%; 1-yr 86%; 3yr 90%
Median survival post-discharge 23 mo
3-yr QOL good for survivors (n=7)
MR: ICU 88%; Hospital 97%; 4 mo 100%
ICU mortality1 – APS >15
Hospital mortality1 – organ failure, no response to
chemo, poor recovery of BM post-chemo
Hospital mortality1 – APACHE II;  organ failure, no
BM recovery post-chemo, relapse, leucopenia
ICU mortality2 – SAPS, combination MV + RRT,
septic shock, ICU LOS
Not evaluated
Lloyd-Thomas
et al[7]
Brunet et al[8]
1988
Retrospective
60
1990
Retrospective
Yau et al[9]
1991
Tremblay et
al[10]
Epner et al[11]
1996
Retrospective
157
HM + MV
No
MR: Hospital 83%
Ewig et al[12]
1998
Retrospective
89
HM
No
MR: ICU 79%
Evison et
al[13]
Rabbat et
al[14]
2001
Retrospective
78
HM
No
MR: ICU 26%; 60 day 41%
2005
Retrospective
83
AML
No
MR: ICU 34%; 12 mo 66%
Massion et
al[15]
2002
Retrospective
84
HM
No
MR: ICU 38%; Hospital 61%; 6 mo 75%
Krochinsky et
al[16]
Benoit et
al[17]
Silfvast et
al[18]
Depuydt et
2002
Retrospective
104
HM
No
MR: ICU 44%; 6 mo 67%; 1-yr 71%
2003
Retrospective
124
HM
No
MR: ICU 42%; Hospital 54%;6 mo 67%
2003
Retrospective
30
HM
No
MR: ICU 43%; 3 mo 77%; 1-yr 80%
2004
Retrospective
166
HM + MV
No
MR: ICU 62%; Hospital 71%
Hospital mortality1 – APACHE II, age, respiratory
failure
ICU mortality1 – age, later stage disease, APS, MV
ICU mortality1 – APACHE II
Hospital mortality2 – age, APACHE III, BMT,
relapse, neutropenia>30 d
ICU mortality2 – MV, BMT
ICU mortality2 – organ failure score
60 d mortality2 – organ failure score, ↑liver enzymes
ICU mortality1 – SAPSII, IMV (vs NIMV), organ
failure score
12 mo mortality2 – no remission
ICU mortality2 – MV, fungal infection
Hospital mortality2 – fungal infection, BMT, MODS,
no improved ∆MODS
6 mo mortality2 – BMT, tumor progression, AML, NHL
ICU mortality2 – MV, SAPS II, CRP
6 mo mortality2 – MV
Hospital mortality2 – leukopenia, vasopressors, urea>12
mmol/L; blood-stream infection
Hospital mortality2 – day 1 SOFA >11, increasing SOFA
1-yr mortality2 – disease status
Hospital mortality2 – male, SAPS II, intubation >24 hr,
1
al[19]
Rabe et al[20]
2004
Retrospective
30
AML + MV
No
Cornet et
al[21]
2005
Retrospective
58
HM
No
Lamia et
al[22]
Cherif et
al[23]
2006
Retrospective
92
HM
No
2007
Retrospective
85
HM (88%)
No
Merz et al[24]
2008
Retrospective
101*
HM
Unmatched
(ICU, n=3808)
Thakkar et
al[25]
2008
Retrospective
85
AML/ALL
Matched
(ward, n=243)
MR: ICU 87%
Median survival from post-discharge 303 d
MR: ICU 62%; 1-yr 88% (overall); 1-yr
67% (discharged); 3-yr 95%
Median survival post-discharge 307 d
MR: ICU 50%; Hospital 58%
MR: ICU 30%; 30 d 49%; 6 mo 62%;
5-yr 80%
MR (HM): Hospital 34%; 28 d 30%;
90 d 40%
MR (ICU controls): Hospital 11%
MR (cases): ICU 68%; Hospital 73%; 6 mo
82%; 12 mo 84%
Median survival: AML 199 d, ALL 192 d
MR (ward controls): 2 mo 15%; 6 mo 31%;
12 mo MR 54%
AML diagnosis
ICU mortality1 – age≥50y, APACHE II>26, refractory
septic shock, transformed AML
ICU mortality1 – SOFA, platelets, INR, bilirubin,
1-yr mortality1 – ∆SOFA (no improvement)
Hospital mortality2 – SAPSII, organ failure scores,
∆organ failure scores (no improvement)
ICU mortality2 – APACHE II, MV
30 d mortality2 – MV
6 mo mortality2 – malignancy
ICU mortality – SAPSII, MV, RRT
Hospital mortality – SAPS II
28 d mortality – 48 hr SOFA, SAPS II
ICU/2 mo mortality2 – BMT chemo, ΔAPACHE II
(worse)
6 mo mortality2 – vasopressors, cytogenetics
12 mo mortality2 – ΔAPACHE II (worse)
Abbreviations: AML = acute myelogenous leukemia, ALL = acute lymphoblastic leukemia, HM = hematologic malignancy (include acute leukemias, chronic leukemias and all
forms of lymphomas), NHL = Non-Hodgkin’s lymphoma, MR = mortality rate, MV = mechanical ventilation, IMV = invasive mechanical ventilation, NIMV = non-invasive
mechanical ventilation, RRT = renal replacement therapy, BMT = bone marrow transplant, chemo = chemotherapy, AT-III = antithrombin III, CRP = C-reactive protein, APS =
acute physiology score, ICU = intensive care unit, QOL = quality of life, d = day, mo = month, yr = year; Δ = delta or change in.
1
= Univariate analysis, 2 = Multivariate analysis,
*Represents consecutive admissions for 84 patients
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