Evidence map›Paper›PMID 42081104›Full record

SynthesisIntensive care medicine2026

Temporal trends and prognostic factors in critically ill adult patients with acute leukemia: an individual participant data meta-analysis.

Dara Chean, Thibault Dupont, Joseph L Nates, Nirmala K Manjappachar, Marijana Medic, Gulbin Aygencel, Corentin Orvain, Achille Kouatchet, Ajay Sheshadri, Tasmea K Haque and 20 more

Abstract readMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Intensive care medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

30 authors.

Dara CheanMedical Intensive Care Unit, AP-HP, Saint-Louis Teaching Hospital, Paris-Cité University, INSERM UMR1342 Institut de Recherche Saint-Louis, Paris, France.ORCID http://orcid.org/0009-0005-7617-4220
Thibault DupontMedical Intensive Care Unit, AP-HP, Saint-Louis Teaching Hospital, Paris-Cité University, INSERM UMR1342 Institut de Recherche Saint-Louis, Paris, France.
Joseph L NatesDivision of Anesthesiology, Critical Care, and Pain Medicine, Department of Critical Care Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Nirmala K ManjappacharDivision of Anesthesiology, Critical Care, and Pain Medicine, Department of Critical Care Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Marijana MedicIntensive Care Unit, Department of Internal Medicine, University Hospital Centre Zagreb, Zagreb, Croatia.
Gulbin AygencelDivision of Intensive Care Medicine, Department of Internal Medicine, Gazi University School of Medicine, Ankara, Turkey.
Corentin OrvainMaladies du Sang, CHU d'Angers, Angers, France.
Achille KouatchetMedical Intensive Care Unit, CHU d'Angers, Angers, France.
Ajay SheshadriDivision of Internal Medicine, Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA.
Tasmea K HaqueDivision of Internal Medicine, Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA.
Lene RussellCopenhagen University Hospital Gentofte, Hellerup, Denmark.
Thomas PabstDepartment of Medical Oncology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
Melda TurkogluDivision of Intensive Care Medicine, Department of Internal Medicine, Gazi University School of Medicine, Ankara, Turkey.
Marlies OstermannGuy's and St Thomas' NHS Foundation Trust, Department of Critical Care, King's College London, Westminster Bridge Road, London, UK.
Marcio SoaresDepartment of Critical Care and Postgraduate Program, D'Or Institute for Research and Education, Rio de Janeiro, Brazil.
Tugba CetintepeDepartment of Hematology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey.
Rena BucksteinOdette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada.
Nahema IssaInternal Medicine and Infectious Disease Unit, Groupe Saint-André, University Hospital, Bordeaux, France.
Djamel MokartDepartment of Anesthesiology and Critical Care, Paoli-Calmettes Institute, Marseille, France.
Pedro CarusoIntensive Care Unit, AC Camargo Cancer Center, São Paulo, Brazil.
Patricia Cornejo-JuarezDepartment of Infectious Diseases, Instituto Nacional de Cancerología, Mexico City, Mexico.
David SchnellMedical-Surgical Intensive Care Unit, Angoulême Hospital, Angoulême, France.
Tobias LahmerTechnical University Munich (TUM) School of Medicine and Health, Department of Clinical Medicine-Clinical Department for Internal Medicine II, University Medical Center, TUM, Munich, Germany.
Sofiane FodilHematology Department, Saint-Louis Teaching Hospital, Paris, France.
Etienne LenglinéHematology Department, Saint-Louis Teaching Hospital, Paris, France.
David Luque-PazInfectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France.
Virginie LemialeMedical Intensive Care Unit, AP-HP, Saint-Louis Teaching Hospital, Paris-Cité University, INSERM UMR1342 Institut de Recherche Saint-Louis, Paris, France.
Daniele PooleEuropean Society of Intensive Care Medicine (ESICM) Methodology Group, Brussels, Belgium.
Michael DarmonMedical Intensive Care Unit, AP-HP, Saint-Louis Teaching Hospital, Paris-Cité University, INSERM UMR1342 Institut de Recherche Saint-Louis, Paris, France.
Elie AzoulayMedical Intensive Care Unit, AP-HP, Saint-Louis Teaching Hospital, Paris-Cité University, INSERM UMR1342 Institut de Recherche Saint-Louis, Paris, France. elie.azoulay@aphp.fr.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeCritically ill patients with acute leukemia often require an intensive care unit (ICU) admission. As major therapeutic advances have been made during the last decades, the aim of this study was to assess temporal trends in ICU mortality, and identify prognostic factors to inform clinician decision-making.

methodsWe conducted an individual participant data meta-analysis of studies including adults with acute leukemia admitted to the ICU. Patients with a history of allogeneic hematopoietic stem cell transplantation were excluded. Mixed-effects logistic regression models, accounting for center of ICU admission as a random variable, evaluated factors associated with ICU mortality, with particular focus on year of ICU admission, age (> 65 years) and invasive mechanical ventilation.

resultsA total of 2003 patients from 55 ICUs across 19 countries were included (median age 58 years [IQR 44-67]; 72% acute myeloid leukemia [AML]; 64% admitted during induction chemotherapy). Invasive mechanical ventilation, vasopressors, and renal replacement therapy were required in 55%, 57%, and 21% of patients, respectively. Crude ICU mortality was 45% overall and 66% among ventilated patients. Age > 65 years (odds ratio (OR) 1.98 [95% CI 1.49-2.64]), diagnosis of AML (OR 1.70 [1.23-2.34]), admission during diagnosis or induction chemotherapy (OR 1.50 [1.08-2.07]), relapsed or refractory disease (OR 2.08 [1.36-3.21]), the need for mechanical ventilation (OR 6.46 [4.84-8.63]), and the need for other life-sustaining therapies (OR 2.21 [1.62-3.02]) were associated with increased ICU mortality. Year of ICU admission was associated with improved survival only among ventilated patients (OR per additional year 0.93 [0.93-0.93]).

conclusionsIn this large international individual participant meta-analysis, survival of critically ill patients with acute leukemia improved over time, particularly among those requiring mechanical ventilation. Age and the need for mechanical ventilation and other life-sustaining therapies remain strong, independent predictors of ICU mortality. Future work should integrate frailty and functional assessments to refine prognostic stratification and guide treatment intensity in this complex population.

trial registrationThe protocol was registered in PROSPERO (CRD420251046286).

Indexed as

Critical IllnessHospital MortalityLeukemia, Myeloid, AcuteAdultAgedAge FactorsFemaleHumansIntensive Care UnitsMaleMiddle AgedPrognosisRespiration, ArtificialAcute leukemiaAcute lymphoid leukemiaAcute myeloid leukemiaIndividual participant data meta-analysisIntensive careMechanical ventilationTemporal trends

Identifiers

PMID42081104

What OpenQuestion holds

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Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.