Advances in the critical care management for patients with hematological malignancies Review


Authors: Azoulay, E.; Zafrani, L.; Nates, J.; Maillard, A.; Chean, D.; Ferreyro, B.; Nelson, J. E.; Bauer, P. R.; Puxty, K.; Gutierrez, C.; Bigé, N.; Mariotte, E.; Valade, S.; Boell, B.; Puntillo, K.; Lafarge, A.; Soares, M.; Schellongowski, P.; Canet, E.; Castro, P.; Demoule, A.; Pène, F.; Munshi, L.; Shimabukuro-Vornhagen, A.; Staudinger, T.; Russell, L.; Fernandez, S.; Kochanek, M.; Lemiale, V.; von Bergwelt-Baildon, M.; Darmon, M.; Martin-Loeches, I.
Review Title: Advances in the critical care management for patients with hematological malignancies
Abstract: Hematological malignancies (HMs) are increasingly associated with life-threatening complications requiring intensive care unit (ICU) management. Recent advancements in therapies, diagnostics, and critical care protocols have improved outcomes for these patients, yet significant challenges persist. This manuscript explores the evolving landscape of critical care in hematology, emphasizing the unique complications, management strategies, and future directions in the field. Patients with HMs are particularly vulnerable to infections, sepsis, organ dysfunction, and treatment-related toxicities such as cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), and coagulopathies. Innovations in the management of acute respiratory failure, septic shock, and invasive fungal infections have contributed to better survival rates, yet outcomes remain suboptimal for certain high-risk groups. Furthermore, new therapies, including CAR-T cells, bispecific antibodies, and immune checkpoint inhibitors, present both opportunities and challenges in the ICU setting due to their potential toxicities. Emerging trends emphasize the importance of early ICU admission, multidisciplinary collaboration, and precision medicine in improving patient care. The integration of biomarker-driven strategies, advanced diagnostics, and artificial intelligence holds promise for optimizing therapeutic interventions and enhancing antimicrobial stewardship. Additionally, patient-centered approaches, including time-limited trials and goal-oriented discussions, aim to balance aggressive care with quality-of-life considerations. This review underscores the need for continued research to address disparities in access to care, improve long-term outcomes, and develop standardized protocols for managing critically ill hematology patients. By advancing the integration of oncology and critical care, clinicians can better navigate the complexities of modern therapies and provide holistic, evidence-based care that aligns with patient values and priorities. © 2025
Keywords: leukemia; survival rate; neutropenia; review; side effect; neurotoxicity; biological marker; quality of life; evidence based practice; transplantation; intensive care; patient care; intensive care unit; hematologic malignancy; artificial intelligence; diagnosis; sepsis; drug therapy; blood clotting disorder; adverse drug reaction; therapy; aspergillosis; health care access; artificial ventilation; personalized medicine; critically ill patient; acute respiratory failure; septic shock; pneumocystis; mechanical ventilation; systemic mycosis; cytokine release syndrome; immune checkpoint inhibitor; bispecific antibody; ventilator; antimicrobial stewardship; human; chimeric antigen receptor t-cell; medrysone
Journal Title: Blood Reviews
ISSN: 0268-960X
Publisher: Churchill Livingstone  
Publication status: Online ahead of print
Date Published: 2025-06-01
Online Publication Date: 2025-06-01
Start Page: 101306
Language: English
DOI: 10.1016/j.blre.2025.101306
PROVIDER: scopus
PUBMED: 40603200
DOI/URL:
Notes: Review -- Source: Scopus
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  1. Judith Eve Nelson
    94 Nelson