AML versus ICU: outcome of septic AML patients in an intensive care setting

Purpose Intensive therapy regimens in patients with acute myeloid leukemia (AML) frequently result in sepsis and septic shock. In this study, we investigated the prognostic outcome of AML patients requiring intensive care treatment due to severe sepsis or septic shock. Design We present a retrospective cohort study in a medical intensive care unit (ICU) of a university hospital that serves as a tertiary care center. Materials and methods Here we present data from 44 AML patients of our ICU with 29 requiring invasive mechanical ventilation due to sepsis and compared multiple clinical and laboratory parameters of ICU survivors and non-survivors. Results Mean age was 59.5 years, the overall mortality rate was 41 % (18/44), and the mortality rate among patients who received mechanical ventilation was 55 % (16/29). The mortality rate among younger patients (aged 60 years or less) was 17 % (3/18), while 58 % of the older patients died (15/26). The mortality rate among younger patients who received mechanical ventilation was 23 % (3/13) compared with 81 % (13/16) of the older patients. The mean invasive ventilation time was 415 h in non-survivors compared with 667 h in survivors. No differences could be identified between survivors and non-survivors, concerning multiple laboratory parameters or AML prognostic and therapeutic parameters; our analysis, however, confirmed a statistically significant difference in the patients’ age. Conclusions In previous studies, age was one of the most important prognostic factors in AML patients receiving mechanical ventilation due to severe sepsis or septic shock. In spite of improvements in diagnostic and treatment over the last couple of years, our study indicates that this fact still is true. However, the overall outcome has improved over the years due to improvements in intensive care medicine.