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Master Thesis

Défaillance circulatoire au cours des hémopathies malignes

Abstract : Introduction: hematological malignancies may induce specific organ failures, including an uncommon acute circulatory failure. Objectives: to describe the clinical presentation, treatment and prognosis of patients with acute circulatory failure due to hematological malignancies. Methods: a retrospective (2006-2016) single-center study. Patients with hematological malignancies receiving chemotherapy during their ICU stay were included. Acute circulatory failure was related to hematological malignancies after excluding other etiologies, particularly septic shock. The occurrence of acute circulatory failure before or after chemotherapy defined primary and secondary shocks, respectively. Endpoints were the time course of organ failures following chemotherapy and survival. Results: seventeen patients with primary shock and six with secondary shock were included. Almost all of them had multiple organ failure requiring both invasive mechanical ventilation and renal replacement therapy. Following the initiation of chemotherapy, a number of patients with primary shock died rapidly from untractable multiple organ failure. In contrast, chemotherapy led to a fast and dramatic improvement in organ failures in early survivors. In secondary chock, chemotherapy worsened organ failures and resulted in early death of two patients. ICU mortality rates were 76% and 83% respectively. Only four patients were discharged alive form the hospital, two of them remaining in complete remission at two years. Conclusion: acute circulatory failure due to hematological malignancies is associated with a dismal prognosis. However, chemotherapy may allow early improvement in organ failures.
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Master Thesis
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  • HAL Id : dumas-02498336, version 1


Marlène Cherruault. Défaillance circulatoire au cours des hémopathies malignes. Médecine humaine et pathologie. 2019. ⟨dumas-02498336⟩



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