Clinical features and outcomes of lymphoma patients admitted in the intensive care department: A real-life experience

BACKGROUND: Patients with haematological malignancies present complex challenges in intensive care units (ICUs), yet few studies have specifically focused on malignant lymphoma in this setting. Our aims were to characterise the epidemiology, identify independent predictors of 1-year survival, and evaluate outcomes in lymphoma patients admitted to the ICU. METHODS: This retrospective, single-centre cohort study collected demographic, haematological, and ICU characteristics of each patient with lymphoma admitted to the ICU at Caen University Hospital between January 2015 and December 2020. Survival at 1 year after ICU admission was analysed, and potential risk factors were assessed. RESULTS: Among 100 lymphoma patients included, the 1-year survival rate was 35%. The multivariate analysis identified four independent predictors of mortality: age >60 years (odds ratio [OR]: 1.88; 95% confidence interval [CI]: [1.43-2.52]), requirement for mechanical ventilation (OR: 2.7; 95%CI: [2.0-4.3]), and elevated respiratory (OR: 3.35; 95%CI: [1.53-6.02]) and neurological (OR: 7.35; 95%CI: [1.98-14.8]) Sequential Organ Failure Assessment score components. In contrast, lymphoma type and disease status at ICU admission were not independently associated with 1-year survival. Hierarchical clustering on principal components analysis revealed three distinct phenotypical clusters, though in-hospital mortality did not significantly differ between them. CONCLUSION: Age, invasive mechanical ventilation, and select Sequential Organ Failure Assessment score components have a significant impact on 1-year survival in ICU-admitted lymphoma patients. The severity of acute organ failure during ICU management appears to have a greater impact on 1-year survival than prognostic factors related to the underlying lymphoma itself.