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The following is a summary of “Critically ill adult patients with acute leukemia: a systematic review and meta-analysis,” published in the January 2025 issue of Critical Care by Chean et al.
Researchers conducted a retrospective study to describe the use of life-sustaining therapies and mortality in individuals with acute leukemia admitted to the intensive care unit (ICU).
They searched the PubMed database from January 1st, 2000, to July 1st, 2023, including all studies on adults with critical illness and acute leukemia, 2 reviewers independently selected studies, assessed bias using the Newcastle-Ottawa scale, and extracted data from full-text readings. A proportional meta-analysis was conducted using a random effects model. The primary outcome was all-cause ICU mortality, while secondary outcomes included reasons for ICU admission, organ support therapies (mechanical ventilation, vasopressors, and renal replacement therapy), and hospital, day-90, and 1-year mortality rates.
The results showed 136 studies (24,861 individuals) met the inclusion criteria, of these, 16,269 (66%) had acute myeloid leukemia, 835 (3%) had acute lymphoblastic leukemia, and 7,757 (31%) had unspecified leukemia. The primary ICU admission causes were acute respiratory failure (70%) and acute circulatory failure (25%). Invasive mechanical ventilation, vasopressors, and renal replacement therapy were required for 65%, 53%, and 23% of individuals, respectively. ICU mortality data from 51 studies (6,668 individuals, 2,956 deaths) revealed a mortality rate of 52% (95% CI [47%; 57%]; I2 93%). A meta-regression identified publication year and intubation rate as factors influencing ICU mortality.
Investigators concluded the acute respiratory failure was the primary cause of ICU admission in patients with acute leukemia on mechanical ventilation serving as the initial life-saving intervention and a significant predictor of mortality.
Source: annalsofintensivecare.springeropen.com/articles/10.1186/s13613-024-01409-9
