Outcomes of Elderly Patients Admitted to the Intensive Care Unit for Newly Diagnosed Acute Myeloid Leukemia

Abstract

Acute myeloid leukemias (AMLs) are the hematological malignancies with the highest need for intensive care unit (ICU) admission due to their association with various life-threatening situations. Limited data exist regarding the outcomes of elderly individuals with AML admitted to the ICU. However, current therapeutic protocols offer the potential for extended survival in this population. This retrospective, monocentric study focused on the outcomes of individuals aged ≥ 60 years admitted to the ICU for newly diagnosed AML. It included 139 patients admitted to the ICU at the Paoli-Calmettes Institute between April 2010 and October 2020, during the initial phase of AML management. Patients were categorized into three groups based on the presence of biological criteria indicating “high risk” for complications (thrombocytopenia < 50 000/mm³ and leukocytosis > 50 000/mm³) and organ failure. Multiple logistic regression models were employed to identify predictive factors for in-hospital and day 90 mortality, while Cox regression was used for 1-year mortality. The rates of in-hospital, day 90, and 1-year mortality were 37%, 42%, and 60%, respectively. Variables associated with in-hospital mortality included the Charlson Comorbidity Index, the need for invasive mechanical ventilation (MV), and multi-organ failure. ELN17 risk was significantly associated with 1-year mortality rates. This study demonstrates the benefits of ICU management for individuals aged ≥ 60 years during the initial phase of AML. It illustrates the effects of age, comorbidities, and the severity of organ failures on short-term mortality and highlights the impact of classical prognostic markers on long-term mortality.