Outcomes of critically ill patients with newly diagnosed Burkitt's lymphoma: a monocentric retrospective study.

BACKGROUND: Burkitt's lymphoma (BL) can lead to intensive care unit (ICU) admission at diagnosis and treatment initiation for management of disease-related complications such as tumor lysis syndrome (TLS) and acute kidney injury (AKI). Data on the outcomes and prognostic factors in this population of critically ill patients remain limited. We conducted a retrospective single-center study including 124 patients admitted to the ICU of Saint-Louis Hospital with newly diagnosed BL between January 1, 2002 and December 31, 2023. Univariate and multivariate survival analyses were performed to determine factors associated with 3 months and 12 months mortality.

RESULTS: 124 patients with a median age of 47.5 years (IQR, 34-58.5) were included, of which 60% (74/124) had HIV infection and a majority had advanced stage disease. Chemotherapy was administered during the ICU stay in 84% (104/124) of patients and 59% (73/124) developed TLS. Ninety-day and one-year mortality were respectively 34% (42/124) and 50% (60/119). Among the 50% (60/119) of patients who survived at one year, 98% (59/60) had achieved complete remission and 90% (52/58) had good functional outcomes (performance status of 0 or 1). In multivariate analysis, TLS, vasopressors, HIV infection, male sex, and increasing age were independently associated with one-year mortality.

CONCLUSIONS: Patients with BL admitted to the ICU during the early phase of their disease present with high rates of TLS, HIV co-infection, and organ failures. Despite low severity scores at admission, short-term and long-term survival remain poor, with half of patients dying within one year. However, among one-year survivors, nearly all achieved complete remission with good functional outcomes. TLS, vasopressor use, HIV infection, male sex, and increasing age were independently associated with one-year mortality.