Hematological malignancies may require rapid-onset treatment because of their short doubling time, notably observed in acute leukemias and specific high-grade lymphomas. Furthermore, in targeted onco-hematological scenarios, chemotherapy is deemed necessary as an emergency measure when facing short-term, life-threatening complications associated with highly chemosensitive hematological malignancies. The risks inherent in the disease itself, or in the initiation of treatment, may then require admission to the intensive care unit (ICU) to optimize monitoring and initial management protocols. Hyperleukocytosis and leukostasis in acute leukemias, tumor lysis syndrome, and disseminated intravascular coagulation are the most frequent onco-hematological complications requiring the implementation of emergency chemotherapy in the ICU. Chemotherapy must also be started urgently in secondary hemophagocytic lymphohistiocytosis. Tumor-induced microangiopathic hemolytic anemia and plasma hyperviscosity due to malignant monoclonal gammopathy represent infrequent yet substantial indications for emergency chemotherapy. In all cases, the administration of emergency chemotherapy in the ICU requires close collaboration between intensivists and hematology specialists. In this review, we provide valuable insights that aid in the identification and treatment of patients requiring emergency chemotherapy in the ICU, offering diagnostic tools and guidance for their overall initial management.

血液恶性肿瘤可能需要快速治疗，因为其倍增时间短，特别是在急性白血病和特定的高级别淋巴瘤中观察到。此外，在有针对性的肿瘤血液学情况下，当面临与高度化学敏感性血液恶性肿瘤相关的短期、危及生命的并发症时，化疗被认为是必要的紧急措施。疾病本身或开始治疗所固有的风险可能需要进入重症监护病房 (ICU) 以优化监测和初始管理方案。急性白血病中的白细胞增多和白细胞停滞、肿瘤溶解综合征和弥散性血管内凝血是最常见的肿瘤血液学并发症，需要在 ICU 实施紧急化疗。继发性噬血细胞性淋巴组织细胞增多症也必须紧急开始化疗。肿瘤引起的微血管病性溶血性贫血和恶性单克隆丙种球蛋白病导致的血浆高粘度是紧急化疗的罕见但重要的适应症。在所有情况下，在 ICU 进行紧急化疗都需要重症医生和血液学专家之间的密切合作。在这篇综述中，我们提供了宝贵的见解，有助于识别和治疗需要在 ICU 进行紧急化疗的患者，并为其整体初始管理提供诊断工具和指导。