Publication Date:
2014-12-06
Description:
Acute lymphocytic leukemia (ALL) and Burkitt lymphoma (BL) are highly aggressive hematologic neoplasms. We analyzed reasons for and the incidence of admission to the intensive care unit (ICU) in de novo ALL/BL patients (pts) as well as their ICU and long-term outcome. A total of 177 consecutive pts (age 15-88 years, f/m ratio 1:1.3), including 135 with ALL (B-ALL, n=12; c-ALL, n=26; prae-B-ALL, n=33; T-ALL, n=28; bcr/abl+ ALL, n=29; T-LBL, n=3; ALL NOS, n=4) and 42 with BL were analyzed retrospectively. First-line chemotherapy (CHT) was administered between 02/1995 and 01/2013 according to the Hšlzer-protocol. In a subset of patients (n=52) hematopoietic stem cell transplantation (HSCT) was performed in complete remission (CR). Thirty-one pts (17.5%) required intensive care, 21 (11.9%) during induction CHT, 6 (3.4%) during conventional post-remission therapy and 4 (2.3%) within one year after HSCT in first CR. In these 31 pts the reasons for ICU admission were «observation after surgery due to malignancy«, therapy-related complications (n=10, 32%), respiratory failure (n=8, 26%), sepsis (n=4, 13%), neurological deterioration (n=3, 10%), renal failure (n=3; 6%) as well as cardiopulmonary resuscitation, bleeding, III¡ AV-blockage and pancreatitis in one patient each. The percentage of ICU admissions was comparable in BL (23%) and ALL (16%; p=0.26). In BL more pts were admitted to the ICU for observation after surgery (50%) compared to ALL patients (23%; p=0.15). Whereas intensive care was required in pts with BL only during the induction phase of CHT (Block A1), ALL pts were admitted during induction as well as during post-remission treatment (conventional CHT or HSCT; p
Print ISSN:
0006-4971
Electronic ISSN:
1528-0020
Topics:
Biology
,
Medicine
Permalink