Multiple systems organ failure in the patient with cancer. Part I: pathophysiologic perspectives

Multiple systems organ failure (MSOF), a phenomenon observed in many critically ill patients with cancer, is the progressive failure of two or more organ systems, which results from nonspecific systemic responses to abnormal intravascular inflammation. It is triggered by a number of cellular, humoral, and biochemical mediators. MSOF in the patient with cancer has been associated with aggressive antineoplastic treatment regimens, which often cause profound alterations in the body's normal homeostatic balance. Part I of this two-part review will discuss the pathophysiology of MSOF, including epidemiology, prognosis, and clinical manifestations. Key relational factors, as well as current and future therapeutic considerations, also will be described.