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Urgent chemotherapy in hematological patients in the ICU. | LitMetric

Urgent chemotherapy in hematological patients in the ICU.

Curr Opin Crit Care

aDepartment of Hematology, Ghent University Hospital, Ghent, Belgium bMedical ICU, Cochin Hospital, Assistance Publique - Hôpitaux de Paris and University Paris Descartes cDepartment of Hematology, Saint-Louis Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France dDepartment of Intensive Care, Ghent University Hospital, Ghent, Belgium.

Published: December 2015

Purpose Of Review: Over the past decades, survival of critically ill hematological patients has dramatically improved, and these patients are more frequently referred to the ICU for intensive treatment, including a rising need for administering anticancer-therapy in this setting.

Recent Findings: The scarce literature on this subject provides evidence for feasibility of administering chemotherapy in the ICU, with expected ICU survival of 60-70%, and one in three patients surviving at least 1 year after discharge. We summarize the recent evidence concerning outcome, dosing and indications of chemotherapy in the ICU, and provide practical guidelines for some special oncological situations.

Summary: Anticancer-therapy in the ICU is feasible and no longer futile as long as it is initiated in a selected, well-informed patient population with reasonable prognostic expectations. Accurate recognition of organ failure and early referral to the ICU for both supportive care and timely administration of chemotherapy is recommended before the development of multisystem organ failure.

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Source
http://dx.doi.org/10.1097/MCC.0000000000000254DOI Listing

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