The following is a summary of “Characteristics and outcomes of patients with acute myeloid leukemia admitted to intensive care unit with acute respiratory failure: a post-hoc analysis of a prospective multicenter study,” published in the September 2023 issue of Critical Care by Secreto et al.

Researchers performed a prospective study to determine prognostic factors affecting short-term outcomes in patients with acute myeloid leukemia (AML) complicated by acute respiratory failure (ARF).

They involved immunocompromised patients admitted to the intensive care unit (ICU) with ARF. The goals were to study hospital mortality and its risk factors in AML patients with ARF and identify subgroups using cluster analysis.

The results showed 1,611 immunocompromised ARF patients, 201 had AML and were analyzed, mortality rate (46.8%). Factors independently associated with mortality included ECOG performance status ≥ 2 (OR = 2.79, P=0.04), cough (OR = 2.94, P=0.034), vasopressor use (OR = 2.79, P=0.044), leukemia-specific pulmonary involvement (leukostasis, pulmonary infiltration by blasts, or acute lysis pneumopathy) (OR = 4.76, P=0.011), and liver SOFA score (OR = 1.85, P=0.014). Focal alveolar chest X-ray pattern was associated with better survival (OR = 0.13, P=0.001). Three ARF clusters were identified: leukemic (high-risk AML, milder ARF), pulmonary (heavily immunocompromised, severe ARF), and inflammatory (multi-organ failures). Clusters 2 and 3 were independently linked to hospital mortality in multivariate analysis.

They concluded that poor performance status and leukemic pulmonary involvement are prognostic factors for worse outcomes in AML patients with ARF.

Source: annalsofintensivecare.springeropen.com/articles/10.1186/s13613-023-01172-3