Résumé
During the last two decades, striking advances in characterization and risk-adapted treatments of haematological malignancies have led to a substantial improvement in long-term survival rates. Thus, patients admitted in intensive care unit, either at diagnosis or during the first line therapy, should be managed as patients that could be potentially cured. The main prognostic factors are detailed in this review. Most of adult patients with acute leukaemia, despite impressive progress, are not cured by chemotherapy (CT) alone, and allogenic stem cell transplantation (ASCT) as post-remission therapy, remains the most effective treatment. In adult acute myeloid leukaemia (AML), only patients with favourable cytogenetics can be cured by CT in more than two-third of the cases and patients with acute promyelocytic leukaemia (APL), since the use of all-trans retinoic acid (ATRA) in combination with CT, have the most favourable outcome with nearly 75% of cure rates. In contrast, patients with unfavourable cytogenetics and older patients have less than 20% of cure rates. In adult acute lymphoblastic leukaemia (ALL), current CT treatments are associated with cure rates of 30 to 40%. As in AML, patients with unfavourable cytogenetics and older patients have a bad prognosis. Patients with mature B cell and T cell phenotypes have gone from having the least favourable outcome to the most favourable outcome. Lymphomas are among the most curable malignancies. Overall, patients with aggressive NHLs have a 5-year survival rate of 50% and patients with Hodgkin disease (HD) can be cured in nearly 75% of the cases. Patients with indolent non-hodgkin lymphoma (NHL), live with a median survival time of 7-10·years from diagnosis.
Titre traduit de la contribution | Prognosis factors for acute leukemias and lymphomas |
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langue originale | Français |
Pages (de - à) | 306-316 |
Nombre de pages | 11 |
journal | Reanimation |
Volume | 11 |
Numéro de publication | 5 |
Les DOIs | |
état | Publié - 1 janv. 2002 |
Modification externe | Oui |
mots-clés
- Acute leukemias
- Critical care
- Lymphoma
- Prognosis