Abstract
Contemporary outcomes for adults with AML requiring ICU admission
Journal of clinical oncology, Vol.39(15_suppl), pp.7025-7025
05/20/2021
DOI: 10.1200/JCO.2021.39.15_suppl.7025
Abstract
Abstract only 7025
Background: Patients (pts) with AML frequently encounter life-threatening complications requiring transfer to an intensive care unit (ICU). Methods: Retrospective analysis of 145 adults with AML requiring ICU admission at our tertiary cancer center 2018-19. Use of life-sustaining therapies (LSTs) and overall survival (OS) were reported using descriptive statistics. Logistic regression was used to identify risk factors for in-hospital death. Results: Median age was 64 yrs (range 18-86). 47% of pts had an ECOG status of ≥ 2 with a median of at least 1 comorbidity (Table). 117 pts (81%) had active leukemia at admission. 68 pts (47%) had poor-risk cytogenetics (CG) and 32 (22%) had TP53-mutated disease. 61 (42%), 27 (19%) and 57 pts (39%) were receiving 1
st
, 2
nd
and ≥ 3
rd
line therapy. 33 (23%) and 70 pts (48%) were receiving intensive and lower-intensity chemotherapy, respectively, and 77 pts (53%) were concurrently on venetoclax. Most common indications for admission were sepsis (32%), respiratory failure (24%) and leukocytosis (12%); Table outlines additional ICU admission details. Median OS from the date of ICU admission was 2.0 months (mo) for the entire cohort and 6.9, 1.6 and 1.2 mo in pts with favorable-, intermediate- and poor-risk CG. Median OS of pts receiving frontline vs. ≥ 2
nd
line therapy was 4.2 vs. 1.4 mo (P<0.001). Median OS in pts requiring 0-1 vs. 2-3 LSTs was 4.1 vs. 0.4 mo (P<0.001). OS was not different by age, co-morbidity burden nor therapy intensity. In a multivariate analysis that included SOFA scores, only adverse CG (OR 0.35, P = 0.028), and need for intubation with mechanical ventilation (IMV; OR 0.19, P = 0.009) were associated with increased odds of in-hospital mortality. Conclusions: A substantial portion of pts with AML survive their ICU admission with sufficient functionality to return home and receive subsequent therapy. In contrast to general medical populations, age, co-morbidities, and SOFA scores were not independently predictive of in-hospital mortality. Disease CG risk and the need for IMV were the strongest predictors of ICU survival. This suggests that many pts with AML can benefit from ICU care.[Table: see text]
Details
- Title: Subtitle
- Contemporary outcomes for adults with AML requiring ICU admission
- Creators
- Danielle Hammond - The University of Texas MD Anderson Cancer CenterKoji Sasaki - The University of Texas MD Anderson Cancer CenterAlexis Geppner - The University of Texas MD Anderson Cancer CenterFadi Haddad - The University of Texas MD Anderson Cancer CenterShehab Mohamed - The University of Texas MD Anderson Cancer CenterDaniel Rivera - The University of Texas MD Anderson Cancer CenterMaria Siddiqui - The University of Texas MD Anderson Cancer CenterYasmin Alwash - The University of Texas MD Anderson Cancer CenterJorge Ramos Perez - The University of Texas MD Anderson Cancer CenterKiyomi Morita - The University of Texas MD Anderson Cancer CenterKunhwa Kim - The University of Texas MD Anderson Cancer CenterSherry Pierce - The University of Texas MD Anderson Cancer CenterCristina Gutierrez - The University of Texas MD Anderson Cancer CenterNaveen Pemmaraju - The University of Texas MD Anderson Cancer CenterGautam Borthakur - The University of Texas MD Anderson Cancer CenterCourtney Denton Dinardo - The University of Texas MD Anderson Cancer CenterFarhad Ravandi - The University of Texas MD Anderson Cancer CenterGuillermo Garcia-Manero - The University of Texas MD Anderson Cancer CenterHagop M. Kantarjian - The University of Texas MD Anderson Cancer CenterTapan M. Kadia - The University of Texas MD Anderson Cancer Center
- Resource Type
- Abstract
- Publication Details
- Journal of clinical oncology, Vol.39(15_suppl), pp.7025-7025
- DOI
- 10.1200/JCO.2021.39.15_suppl.7025
- ISSN
- 0732-183X
- eISSN
- 1527-7755
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS; PHILADELPHIA
- Number of pages
- 1
- Grant note
- U.S. National Institutes of Health
U.S. National Institutes of Health
- Language
- English
- Date published
- 05/20/2021
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984920891302771
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