Annals of Hematology

, Volume 98, Issue 1, pp 195–203 | Cite as

Intensive care unit admission in patients with T cell lymphomas: clinical features and outcome

  • Guillaume DumasEmail author
  • Lucie Biard
  • Claire Givel
  • Sandy Amorim
  • Lara Zafrani
  • Virginie Lemiale
  • Eric Mariotte
  • Elie Azoulay
  • Catherine Thiéblemont
  • Emmanuel Canet
Original Article


T cell non-Hodgkin lymphomas (T-NHLs) are aggressive malignancies which have a high risk of life-threatening complications. However, their prognosis in the intensive care unit (ICU) setting has not yet been assessed. We conducted a study including 87 ICU patients either with newly diagnosed T-NHLs or those undergoing first-line therapy admitted between January 1, 2000, and December 31, 2014. The primary subtypes were peripheral T cell lymphoma (PTCL) (n = 41, 47%), anaplastic large-cell lymphoma (ALCL) (n = 13, 15%), and adult T-leukaemia/lymphoma (ATLL) (n = 11, 13%). Six in every ten patients had malignancy-related complications (haemophagocytic syndrome 37%, tumour lysis syndrome 18% and hypercalcaemia 9%), while infections accounted for one quarter of ICU admissions. Nine fungal infections were documented, including six invasive aspergillosis. Urgent chemotherapy was started in the ICU in 59% of the patients, and urgent surgery was required in 13%. ICU and day-90 mortality were 22% and 41%, respectively. Multivariate analysis showed that SOFA score at day 1, age, sepsis and haemophagocytic syndrome were independent predictors of day-90 mortality. Compared to 66 ICU-matched controls with non-Hodgkin B cell lymphomas, patients with T-NHLs had a similar ICU survival. Overall survival rates of patients with T cell NHLs and B cell NHLs were 20% and 46%, respectively (hazard ratio for death associated with T cell NHLs 2.00 [1.12–3.58]). Patients with T cell NHLs had a very poor long-term outcome. Although the high rate of short-term survival suggests that an ICU trial is a reasonable option for patients newly diagnosed for the malignancy, extended stay in the ICU or further readmission should be considered only for highly selected patients who respond to the haematological treatment.


Fungal infection Haemophagocytic syndrome Intensive care unit T cell lymphoma Tumour lysis syndrome 



angioimmunoblastic T cell lymphoma


anaplastic large-cell lymphoma ALK+


adult T cell leukaemia/lymphoma


area under the curve


chronic obstructive pulmonary disease


human immunodeficiency virus


haematological malignancies


hepatosplenic T cell lymphoma


intensive care Unit


invasive fungal infection


international pronostic index


interquartile range


lactate dehydrogenase


non-Hodgkin’s lymphoma


NK/T cell lymphoma


performance status


peripheral T cell Lymphoma-Not otherwise specified


peripheral T cell lymphomas


sequential organ failure assessment



We thank Victoria Mears for helping with English editing.

Compliance with ethical standards

This study was approved by our institutional review board (CECIC Clermont Ferrand – IRB no.5891; Ref. 2007-16). According to French law, informed consent was not required in this retrospective observational study in which the collected data were anonymised.

Conflict of interest

GD, LB, CG, SA, LZ, VL, EM, CT and EC declare that they have no competing interests. EA declares the following statements: board member for Gilead, lectures for Alexion, MSD, Astellas, and research grants from MSD, Fisher & Payckle, Pfizer (2012).

Supplementary material

277_2018_3496_MOESM1_ESM.docx (17 kb)
Supplementary Table 1 (DOCX 81 kb)
277_2018_3496_MOESM2_ESM.docx (69 kb)
Supplementary Table 2 (DOCX 68 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Guillaume Dumas
    • 1
    Email author
  • Lucie Biard
    • 2
  • Claire Givel
    • 1
  • Sandy Amorim
    • 3
  • Lara Zafrani
    • 1
    • 4
  • Virginie Lemiale
    • 1
  • Eric Mariotte
    • 1
  • Elie Azoulay
    • 1
    • 4
  • Catherine Thiéblemont
    • 3
    • 4
  • Emmanuel Canet
    • 1
  1. 1.Medical Intensive Care Unit, AP-HPSaint-Louis University HospitalParisFrance
  2. 2.Biostatistics Department, AP-HPSaint-Louis University HospitalParisFrance
  3. 3.Hemato-Oncology DepartmentSaint-Louis University HospitalParisFrance
  4. 4.Paris Diderot University, Sorbonne Paris CitéParisFrance

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