01.12.2017 | Research article | Ausgabe 1/2017 Open Access

A systematic review of prognostic factors at the end of life for people with a hematological malignancy
- Zeitschrift:
- BMC Cancer > Ausgabe 1/2017
Electronic supplementary material
Background
Methods
Data sources
Selection criteria
Inclusion criteria
|
Exclusion criteria
|
---|---|
• English language only
• Human research subjects with a hematological malignancy (>50% of study sample)
• Adult patients (≥18 years of age)
• Primary research
• Peer reviewed articles
• Studies from January 2004 to November 2014
• Prognostic studies (cohort or case-control)
• Median survival of ≤ 3 months, (or >50% sample had died in ICU, or in hospital or within 3 months)
• Reported ‘bedside prognostic factors’
|
• Editorials and letters
• Discussions / expert opinion papers
• Non - peer reviewed
• Reports of clinical trials evaluating the effects of a specific treatment (chemotherapy, radiation therapy, etc.)
• Systematic reviews of original research (predictive/prognostic cohort studies)
|
Quality assessment
Analysis
Results
Study selection
Study characteristics
Author, Year, Country
|
Design
|
Sample characteristics
|
Hem malig
|
N
|
Analysis
|
Quality rating (QUIPS)
|
---|---|---|---|---|---|---|
Rabe et al., (2004)
Germany [
41]
|
Retro
|
Admitted to ICU, with pulmonary infiltrates, requiring ventilation
|
AML
|
30
|
Uni
-
|
Mod
|
Soubani et al., (2004)
USA [
30]
|
Retro
|
Admitted to ICU
|
HSCT
|
85
|
Uni
Multi
|
Mod
|
BaHammam et al. (2005)
Saudi Arabia [
51]
|
Retro
|
Admitted to ICU
|
All
|
44
|
Uni
-
|
Mod
|
Owczuk et al., (2005)
Poland [
37]
|
Retro
|
Admitted to ICU, requiring ventilation
|
HSCT
|
40
|
Uni
Multi
|
Mod
|
Naeem et al., (2006)
USA [
34]
|
Retro
|
Admitted to ICU
|
Cord HSCT
|
44
|
Uni
-
|
Mod
|
Ferra et al., (2006)
Spain [
46]
|
Retro
|
Admitted to ICU
|
All
|
100
|
Uni
Multi
|
Mod
|
Lim et al., (2007)
UK [
33]
|
Retro
|
Admitted to ICU
|
All
|
55
|
Uni
-
|
Mod
|
Yang et al., (2007)
Taiwan [
31]
|
Retro
|
Admitted to ICU, requiring ventilation
|
HSCT
|
41
|
Uni
-
|
Mod
|
Nishida & Palalay, (2008)
USA [
36]
|
Retro
|
Admitted to ICU, requiring ventilation
|
All
|
37
|
Uni
-
|
Mod
|
Park et al., (2008)
Korea [
38]
|
Retro
|
Admitted to ICU for septic shock
|
Acute leuk
|
50
|
Uni
Multi
|
High
|
Chen et al., (2009)
Taiwan [
54]
|
Retro
|
Intracranial hemorrhage (in-patient acute setting)
|
AML
|
51
|
Uni
Multi
|
High
|
Hampshire et al., (2009)
UK [
48]
|
Retro
|
Admitted to ICU (multi-centre)
|
All
|
7689
|
-
Multi
|
Mod
|
des Ordons et al., (2010)
USA [
44]
|
Retro
|
Admitted to ICU
|
AML
|
45
|
Uni
-
|
High
|
Burghi et al., (2011)
France [
53]
|
Retro
|
Admitted to ICU, invasive pulmonary aspergillosis, ventilated
|
All
|
67
|
Uni
Multi
|
High
|
Depuydt et al., (2011)
Belgium [
43]
|
Pro
|
Admitted to ICU
|
Allo
HSCT
|
44
|
Uni
Multi
|
Mod
|
Geerse et al., (2011)
Netherlands [
47]
|
Retro
|
Admitted to ICU
|
All
|
86
|
Uni
Multi
|
Mod
|
Park et al., (2011)
Korea [
39]
|
Retro
|
Admitted to ICU, with AKI, requiring RRT
|
All
|
94
|
Uni
Multi
|
Mod
|
Ramos et al., (2011)
USA [
55]
|
Retro
|
Invasive aspergillosis (in-patient acute setting)
|
HSCT
|
449
|
Uni
Multi
|
Mod
|
Agarwal et al. (2012)
Australia [
50]
|
Retro
|
Admitted to ICU
|
HSCT
|
146
|
Uni
Multi
|
High
|
Ferra et al., (2012)
Spain [
45]
|
Retro
|
Admitted to ICU
|
Lymphoma
|
48
|
Uni
Multi
|
Low
|
Hill et al., (2012)
UK [
49]
|
Retro
|
Admitted to ICU (multi-centre)
|
All
|
147
|
Uni
Multi
|
Mod
|
Yeo et al., (2012)
Korea [
32]
|
Retro
|
Admitted to ICU
|
All
|
227
|
Uni
Multi
|
Mod
|
Corbett et al., (2013)
Australia [
56]
|
Retro
|
Referred to specialist palliative care service (in-pt. & out-pt. setting)
|
All
|
276
|
-
Multi
|
Mod
|
de Montmollin et al., (2013)
France [
42]
|
Retro
|
Admitted to ICU, with septic shock, pulmonary origin (multi-centre)
|
All
|
218
|
Uni
Multi
|
Mod
|
Namendys-Silva et al., (2013)
Mexico [
35]
|
Pro
|
Admitted to ICU
|
All
|
102
|
Uni
Multi
|
Mod
|
Price et al., (2013)
USA [
40]
|
Retro
|
Admitted to ICU, requiring ventilation
|
Acute leuk
|
167
|
Uni
Multi
|
Mod
|
Kripp et al., (2014)
Germany [
57]
|
Pros
|
Admitted to palliative care unit
|
All
|
290
|
Uni
Multi
|
Mod
|
Boyaci et al., (2014)
Turkey [
52]
|
Retro
|
Admitted to ICU
|
HSCT
|
48
|
Uni
Multi
|
Mod
|
Quality of studies
Patient characteristics
Analysis in studies
Prognostic factors identified
Prognostic factor
|
Number of studies
|
Total # of pts., N
|
Univariate analysis
Significant/ tested/% significant
|
Multivariable analysis
Significant/ tested/% significant
|
Hematological malignancies tested
|
---|---|---|---|---|---|
Older age
|
22
|
10,027
|
6/20
(30%)
|
5/16
(31%)
|
• Acute leukemia
• All hematological malignancies
• AML
• Cord HSCT
• HSCT
|
Mechanical ventilation
|
18
|
9702
|
13/17
(76%)
|
12/14
(86%)
|
• Acute leukemia
• All hematological malignancies Cord HSCT
• HSCT
• Lymphoma
|
Vasopressors use
|
15
|
1300
|
12/15
(80%)
|
8/9
(89%)
|
• Acute leukemia
• All hematological malignancies
• AML
• Cord HSCT
• HSCT
|
Renal replacement therapy
|
7
|
633
|
3/7
(43%)
|
3/4
(75%)
|
• All hematological malignancies
• AML
• HSCT
|
Transfusions
|
4
|
490
|
2/4
(50%)
|
2/4
(50%)
|
• Acute leukemia
• All hematological malignancies
• HSCT
|
Admission to intensive care unit
|
1
|
85
|
1/1
(100%)
|
1/1
(100%)
|
• HSCT
|
Artificial feeding
|
1
|
290
|
1/1
(100%)
|
1/1
(100%)
|
• All hematological malignancies
|
Opiate analgesia
|
1
|
290
|
1/1
(100%)
|
1/1
(100%)
|
• All hematological malignancies
|
Sepsis/infection
|
17
|
9170
|
9/16
(56%)
|
8/14
(57%)
|
• Acute leukemia
• All hematological malignancies
• AML
• HSCT
• Lymphoma
|
Hemodynamic instability
|
9
|
8095
|
6/8
(75%)
|
5/8
(62%)
|
• All hematological malignancies
• AML
• Cord HSCT
• HSCT
• Lymphoma
|
Multi organ failure
|
9
|
657
|
6/8
(75%)
|
5/6
(83%)
|
• All hematological malignancies
• HSCT
|
Respiratory distress/failure
|
13
|
8715
|
5/12
(42%)
|
5/10
(50%)
|
• Acute leukemia
• All hematological malignancies AML
• Cord HSCT
• HSCT
• Lymphoma
|
Cardiovascular function
|
5
|
711
|
3/5
(60%)
|
3/5
(60%)
|
• All hematological malignancies
• HSCT
• Acute leukemia
|
Decreased level of consciousness
|
10
|
1169
|
3/9
(33%)
|
3/8
(37%)
|
• Acute leukemia
• All hematological malignancies
• HSCT
• Lymphoma
|
Renal dysfunction
|
8
|
8205
|
2/6
(33%)
|
2/3
(66%)
|
• Acute leukemia
• All hematological malignancies
• AML
• Cord HSCT
• HSCT
• Lymphoma
|
Fungal infection
|
4
|
382
|
2/4
(50%)
|
2/4
(50%)
|
• Acute leukemia
• All hematological malignancies
• HSCT
|
Liver dysfunction
|
7
|
478
|
3/7
(43%)
|
3/4
(75%)
|
• Acute leukemia
• AML
• Cord HSCT
• All hematological malignancies
• HSCT
|
Pneumonia
|
4
|
173
|
2/4
(50%)
|
0/1
(0%)
|
• All hematological malignancies
• Cord HSCT
• HSCT
|
CMV reactivation
|
1
|
86
|
1/1
100%
|
0/1
0%
|
• All hematological malignancies
|
Performance status
|
4
|
775
|
1/4
(25%)
|
1/4
(25%)
|
• Acute leukemia
• All hematological malignancies
|
Disease characteristics
|
|||||
Acute leukemia
|
11
|
9352
|
2/10
(20%)
|
4/10
(40%)
|
• All hematological malignancies
• Cord HSCT
• HSCT
|
Relapse or advanced disease
|
10
|
862
|
4/10
(40%)
|
4/8
(50%)
|
• Acute leukemia
• All hematological malignancies
• AML
• Cord HSCT
• HSCT
|
HSCT
|
9
|
8617
|
1/8
(12%)
|
1/7
(14%)
|
• All hematological malignancies
• HSCT
|
Laboratory values
|
|||||
Liver enzymes
|
11
|
823
|
7/11
(64%)
|
5/6
(83%)
|
• Acute leukemia
• All hematological malignancies
• AML
• HSCT
|
Urea or creatinine
|
11
|
8294
|
5/10
(50%)
|
3/7
(43%)
|
• Acute leukemia
• All hematological malignancies
• AML
• Cord HSCT
• HSCT
|
Neutropenia or leukopenia
|
15
|
9244
|
5/14
(36%)
|
5/12
(42%)
|
• All hematological malignancies
• AML
• HSCT
|
Thrombocytopenia
|
10
|
8614
|
5/9
(55%)
|
4/6
(67%)
|
• All hematological malignancies
• AML
• Cord HSCT
• HSCT
|
Coagulopathy
|
8
|
512
|
4/7
(57%)
|
3/4
(75%)
|
• Acute leukemia
• All hematological malignancies
• AML
• HSCT
• Lymphoma
|
Anemia
|
4
|
477
|
4/4
(100%)
|
4/4
(100%)
|
• All hematological malignancies
• HSCT
|
Blood pH
|
3
|
7960
|
2/3
(66%)
|
2/2
(100%)
|
• All hematological malignancies
|
Calcium
|
2
|
338
|
2/2
(100%)
|
2/2
(100%)
|
• All hematological malignancies
• HSCT
|
CRP
|
3
|
368
|
2/3
(66%)
|
2/2
(100%)
|
• All hematological malignancies
• AML
• HSCT
|
Hematocrit
|
4
|
7859
|
1/3
(33%)
|
2/4
(50%)
|
• All hematological malignancies
|
Hypoalbuminemia
|
5
|
570
|
2/5
(40%)
|
2/4
(50%)
|
• All hematological malignancies
• AML
• HSCT
|
Lactate
|
2
|
133
|
2/2
(100%)
|
2/2
(100%)
|
• HSCT
|
LDH
|
2
|
7737
|
2/2
(100%)
|
2/2
(100%)
|
• All hematological malignancies
• HSCT
|
Sodium
|
2
|
338
|
½
(50%)
|
2/2
(100%)
|
• All hematological malignancies
• HSCT
|
Bicarbonate
|
1
|
48
|
1/1
(100%)
|
1/1
(100%)
|
• HSCT
|
Pro-calcitonin
|
1
|
48
|
1/1
(100%)
|
1/1
(100%)
|
• HSCT
|
Uric acid
|
1
|
48
|
1/1
(100%)
|
1/1
(100%)
|
• HSCT
|