Aggressive therapy in acute respiratory failure from leukemic pulmonary infiltrates

Three young adults with respiratory failure as a first or early manifestation of acute leukemia were hospitalized. Aggressive support with mechanical ventilation, high fractions of inspired oxygen, and positive end-expiratory pressure provided time for appropriate chemotherapy to be used. One patient was alive, with the disease controlled, 18 months after these events. The other two patients responded to therapy but died subsequently from other aspects of their disease. With the advent of effective specific chemotherapy, the onset of acute respiratory failure in the presence of certain malignancies in young adults should not be considered a terminal event when no other organ is involved.