title: [Critical care of Onco-hematology patients: new therapeutic targets, new complications and new admission policies].
abstract: Overall prognosis of cancer or haematological has dramatically decreased over the last decades. Thus advances regarding cancer or haematological treatment, improved knowledge of usual complications and of their pathophysiology and changes in ICU admission policy and management are among factors which participated to the overall prognostic changes. Tyrosine-Kinase inhibitors in patients with chronic myeloid leukemia and anti-CD20 antibodies in patients with non-hodgkin's lymphoma were among the first success of targeted therapies. These success stories have been followed by others and no less than 13 targeted therapies were available for cancer patients in December 2013. Additionally, pathophysiology of complication is better understood and prognostic impact of organ failure better apprehended. Standardized diagnostic criteria of tumor lysis syndrome along with improved understanding of short-term and long term influence of acute kidney injury (AK) in this setting have led to specific management strategiesfocusing on prevention. In non-malignant haematological diseases, pathophysiological processes leading to thrombotic thrombocytopenic purpura or atypical haemolytic and uremic syndrome are now better understood leading to additional therapeutic options. Last, diversification of ICU admission policies may help in taking into account uncertainties, therapeutic advances and patients' autonomy. This review will give an overview of these recent advances.
authors.forename: Etienne
authors.initials: E
authors.lastname: Lengline
authors.forename: Michael
authors.initials: M
authors.lastname: Darmon
authors.forename: Elie
authors.initials: E
authors.lastname: Azoulay
authors.forename: Jean-Roger
authors.initials: JR
authors.lastname: Le Gall
mesh_terms: D003422:Critical Care; D019337:Hematologic Neoplasms / Q000150:complications* / Q000628:therapy*; D006801:Humans; D010343:Patient Admission