维持癌症治疗的剂量强度是侵袭性血液恶性肿瘤的重要预后因素。本研究的目的是评估患有急性髓系白血病 (AML) 或侵袭性 B 细胞非霍奇金淋巴瘤 (B-NHL) 的重症监护病房 (ICU) 幸存者的长期结果，重点是恢复预期的治疗癌症治疗的最佳方案。我们进行了一项回顾性（2013-2021）单中心观察研究，其中纳入了意外入院后从 ICU 存活下来的 AML 和 B-NHL 患者。主要终点是 ICU 出院后预期最佳癌症治疗的变化。次要终点是 1 年无进展生存率和总生存率。通过多变量逻辑回归评估与癌症治疗修改相关的决定因素。在研究期间，366 名 AML 或 B-NHL 患者入住 ICU，其中 170 名 AML (n = 92) 和 B-NHL (n = 78）形成了感兴趣的群体。 68% 的患者最近被诊断出患有血液恶性肿瘤。入院序贯器官衰竭评估 (SOFA) 评分为 5（四分位距 4-8）。在 ICU 住院期间，30 名患者（17.6%）需要有创机械通气，29 名患者（17.0%）需要升压药物支持，16 名患者（9.4%）需要肾脏替代治疗。出院后 ICU 的一年生存率为 59.5%。 72 名患者 (42%) 需要进一步修改血液治疗方案。在多变量分析中，年龄 > 65岁（比值比（OR）3.54 [95%-置信区间1.67-7.50]，p < 0.001），ICU出院高胆红素血症 > 20 µmol/L（OR 3.01 [1.10-8.15]，p = 0.031）和治疗限制（OR 16.5 [1.83-149.7]，p= 0.012）与癌症治疗的修改独立相关。 ICU 后癌症治疗的修改对院内 1 年总生存率和无进展生存率具有显着影响。 58% 患有侵袭性血液恶性肿瘤的 ICU 幸存者可以恢复预期的癌症治疗。出院时，高龄、持续性肝功能障碍和限制进一步生命支持治疗的决定是癌症治疗调整的独立决定因素。这些修改与恶化的一年结果相关。© 2024。作者。

Maintaining the dose-intensity of cancer treatment is an important prognostic factor of aggressive hematological malignancies. The objective of this study was to assess the long-term outcomes of intensive care unit (ICU) survivors with acute myeloid leukemia (AML) or aggressive B-cell non-Hodgkin lymphoma (B-NHL) with emphasis on the resumption of the intended optimal regimen of cancer treatment.We conducted a retrospective (2013-2021) single-center observational study where we included patients with AML and B-NHL discharged alive from the ICU after an unplanned admission. The primary endpoint was the change in the intended optimal cancer treatment following ICU discharge. Secondary endpoints were 1-year progression-free survival and overall survival rates. Determinants associated with modifications in cancer treatment were assessed through multivariate logistic regression.Over the study period, 366 patients with AML or B-NHL were admitted to the ICU, of whom 170 survivors with AML (n = 92) and B-NHL (n = 78) formed the cohort of interest. The hematological malignancy was recently diagnosed in 68% of patients. The admission Sequential Organ Failure Assessment (SOFA) score was 5 (interquartile range 4-8). During the ICU stay, 30 patients (17.6%) required invasive mechanical ventilation, 29 (17.0%) vasopressor support, and 16 (9.4%) renal replacement therapy. The one-year survival rate following ICU discharge was 59.5%. Further modifications in hematologic treatment regimens were required in 72 patients (42%). In multivariate analysis, age > 65 years (odds ratio (OR) 3.54 [95%-confidence interval 1.67-7.50], p < 0.001), ICU-discharge hyperbilirubinemia > 20 µmol/L (OR 3.01 [1.10-8.15], p = 0.031), and therapeutic limitations (OR 16.5 [1.83-149.7], p = 0.012) were independently associated with modifications in cancer treatment. Post-ICU modifications of cancer treatment had significant impact on in-hospital, 1-year overall survival and progression-free survival.The intended cancer treatment could be resumed in 58% of ICU survivors with aggressive hematological malignancies. At the time of ICU discharge, advanced age, persistent liver dysfunction and decisions to limit further life-support therapies were independent determinants of cancer treatment modifications. These modifications were associated with worsened one-year outcomes.© 2024. The Author(s).