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Annals of Hematology

, Volume 93, Issue 10, pp 1629–1636 | Cite as

Prognostic factors, long-term survival, and outcome of cancer patients receiving chemotherapy in the intensive care unit

  • Philipp Wohlfarth
  • Thomas Staudinger
  • Wolfgang R. Sperr
  • Andja Bojic
  • Oliver Robak
  • Alexander Hermann
  • Klaus Laczika
  • Alexander Carlström
  • Katharina Riss
  • Werner Rabitsch
  • Marija Bojic
  • Paul Knoebl
  • Gottfried J. Locker
  • Maria Obiditsch
  • Valentin Fuhrmann
  • Peter SchellongowskiEmail author
  • Arbeitsgruppe für hämato-onkologische Intensivmedizin der Österreichischen Gesellschaft für Internistische und Allgemeine Intensivmedizin und Notfallmedizin (ÖGIAIN)
Original Paper

Abstract

Prognostic factors and outcomes of cancer patients with acute organ failure receiving chemotherapy (CT) in the intensive care unit (ICU) are still incompletely described. We therefore retrospectively studied all patients who received CT in any ICU of our institution between October 2006 and November 2013. Fifty-six patients with hematologic (n = 49; 87.5 %) or solid (n = 7; 12.5 %) malignancies, of which 20 (36 %) were diagnosed in the ICU, were analyzed [m/f ratio, 33:23; median age, 47 years (IQR 32 to 62); Charlson Comorbidity Index (CCI), 3 (2 to 5); Simplified Acute Physiology Score II (SAPS II), 50 (39 to 61)]. The main reasons for admission were acute respiratory failure, acute kidney failure, and septic shock. Mechanical ventilation and vasopressors were employed in 34 patients (61 %) respectively, hemofiltration in 22 (39 %), and extracorporeal life support in 7 (13 %). Twenty-seven patients (48 %) received their first CT in the ICU. Intention of therapy was cure in 46 patients (82 %). Tumor lysis syndrome (TLS) developed in 20 patients (36 %). ICU and hospital survival was 75 and 59 %. Hospital survivors were significantly younger; had lower CCI, SAPS II, and TLS risk scores; presented less often with septic shock; were less likely to develop TLS; and received vasopressors, hemofiltration, and thrombocyte transfusions in lower proportions. After discharge, 88 % continued CT and 69 % of 1-year survivors were in complete remission. Probability of 1- and 2-year survival was 41 and 38 %, respectively. Conclusively, administration of CT in selected ICU cancer patients was feasible and associated with considerable long-term survival as well as long-term disease-free survival.

Keywords

Chemotherapy Acute leukemia Lymphoma Cancer Intensive care unit Tumor lysis syndrome 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Philipp Wohlfarth
    • 1
  • Thomas Staudinger
    • 1
  • Wolfgang R. Sperr
    • 1
  • Andja Bojic
    • 1
  • Oliver Robak
    • 1
  • Alexander Hermann
    • 1
  • Klaus Laczika
    • 1
  • Alexander Carlström
    • 1
  • Katharina Riss
    • 1
  • Werner Rabitsch
    • 1
  • Marija Bojic
    • 1
  • Paul Knoebl
    • 1
  • Gottfried J. Locker
    • 1
  • Maria Obiditsch
    • 2
  • Valentin Fuhrmann
    • 3
  • Peter Schellongowski
    • 1
    Email author
  • Arbeitsgruppe für hämato-onkologische Intensivmedizin der Österreichischen Gesellschaft für Internistische und Allgemeine Intensivmedizin und Notfallmedizin (ÖGIAIN)
  1. 1.Department of Medicine I, Intensive Care Unit 13i2, Comprehensive Cancer CenterMedical University of ViennaViennaAustria
  2. 2.Pharmacy DepartmentVienna General HospitalViennaAustria
  3. 3.Department of Medicine III, Intensive Care Unit 13h1Medical University of ViennaViennaAustria

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