title: Urgent chemotherapy in hematological patients in the ICU.
abstract: OBJECTIVE
  Over the past decades, survival of critically ill hematological patients has dramatically improved, and these patients are more frequently referred to the ICU for intensive treatment, including a rising need for administering anticancer-therapy in this setting.
  
  
  RESULTS
  The scarce literature on this subject provides evidence for feasibility of administering chemotherapy in the ICU, with expected ICU survival of 60-70%, and one in three patients surviving at least 1 year after discharge. We summarize the recent evidence concerning outcome, dosing and indications of chemotherapy in the ICU, and provide practical guidelines for some special oncological situations.
  
  
  CONCLUSIONS
  Anticancer-therapy in the ICU is feasible and no longer futile as long as it is initiated in a selected, well-informed patient population with reasonable prognostic expectations. Accurate recognition of organ failure and early referral to the ICU for both supportive care and timely administration of chemotherapy is recommended before the development of multisystem organ failure.
authors.affiliation: aDepartment of Hematology, Ghent University Hospital, Ghent, Belgium bMedical ICU, Cochin Hospital, Assistance Publique - Hôpitaux de Paris and University Paris Descartes cDepartment of Hematology, Saint-Louis Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France dDepartment of Intensive Care, Ghent University Hospital, Ghent, Belgium.
authors.forename: Ine
authors.initials: I
authors.lastname: Moors
authors.forename: Frédéric
authors.initials: F
authors.lastname: Pène
authors.forename: Étienne
authors.initials: É
authors.lastname: Lengline
authors.forename: Dominique
authors.initials: D
authors.lastname: Benoit
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003422:Critical Care / Q000458:organization & administration*; D016638:Critical Illness; D019337:Hematologic Neoplasms / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D011379:Prognosis; D011788:Quality of Life; D012720:Severity of Illness Index; D013727:Terminal Care
chemical_list: D000970:Antineoplastic Agents