Extracorporeal membrane oxygenation for adults with active malignancy: Is there difference to clinical outcome between hematologic and oncologic?

We selectively used ECMO for hematologic malignancy (HM) and oncologic malignancy (OM) and estimated to clinical outcomes. We conducted retrospective observational study for compare to clinical outcomes of ECMO between January 2012 and December 2016 in a single center registry. We included critically ill adult patients with active malignancy who received ECMO support for respiratory or cardiac failure despite maximal conventional therapy. Of 98 eligible patients, 30 (30.6%) were diagnosed with HM and 68 (69.4%) were diagnosed with OM. HM patients were younger, more neutropenic, more hypotensive, and had a lower charlson comorbidity index, higher sequential organ failure assessment score, and lower platelet count. Forty-six (46.9%) patients were successfully weaned from ECMO, and 30 (30.6%) survived till hospital discharge. Hospital survival rate was significantly lower in HM (13.3 vs 38.2%, p=0.026). Survival status at six months after hospital discharge was also significantly lower in HM patients (3.3 vs 26.5%, p=0.017). In multivariate analysis, hematologic malignancy, old age, acidosis, thrombocytopenia, high vasoactive inotrope score, and respiratory failure were risk factors for in-hospital death. HM patients who required ECMO support had significantly lower hospital survival rate than OM patients. Six-month survival after discharge was extremely low in the HM patients.