Emergencies in malignant hematology

Abstract

Patients with hematological malignancies represent an increasing proportion of patients in intensive care unit with a prognosis that has generally improved over the last decades due in particular to earlier admission of these patients to intensive care unit but also due to the emergence of new hematological therapies (targeted therapies, immunotherapy). Therefore, beside the classic complications related to hematological malignancies (compression and/or infiltration of organs, tumor lysis syndrome, disseminated intravascular coagulation, haemophagocytic lymphohistiocytosis syndrome) and conventional chemotherapy (mainly infectious complications), the emergencies of these patients become more complex with a multitude of so-called “inflammatory” complications that the intensivists must learn to recognize. The therapeutic strategy is then different, based on immunosuppressors (most often first-line corticosteroids). This diversification of hematological malignant emergencies requires close collaboration with the hematology team in order to adopt the most appropriate diagnostic and therapeutic strategy.