Factors associated with treatment resumption and long-term outcomes after ICU discharge in patients with hematological malignancies.

Purpose: Post-intensive care syndrome may result in persistent functional impairments that may jeopardize the feasibility of anticancer therapy in patients with hematological malignancies (HMs), thereby adversely affecting long-term survival. Our purpose was to identify factors associated with anticancer therapy resumption after ICU discharge and to assess five-year survival. Methods: This single-center retrospective observational study included consecutive adults with HMs admitted to intensive care unit (ICU) between 2014 and 2019. Multivariable analyses were performed to identify factors associated with anticancer treatment resumption and with survival. Results: We included 252 patients. The most common malignancies were aggressive lymphoma (n = 71, 28.2%), acute leukemia (n = 47, 18.7%), and multiple myeloma (n = 42, 16.7%). Performance status worsened significantly during the ICU stay (median change, -1.0; 95%CI, -1.0 to -1.0; Conclusions: In patients with HMs, ICU survival was substantial and most deaths occurred during the ICU stay or within the first post-ICU year. Most survivors were able to resume anticancer therapy despite exhibiting functional decline. Long-term outcomes in survivors were primarily related to the nature of the underlying disease and to cardiovascular comorbidities. Both the oncological prognosis and the cardiovascular status should be considered when making intensive-care decisions.