Les patients atteints d’hémopathies ou de cancers solides sont exposés à un risque important de complications vitales. La décennie passée a vu se modifier progressivement le paradigme du pronostic de ces patients. Ainsi, de nouvelles approches thérapeutiques ciblées ont transformé les capacités de guérison de certaines hémopathies. À travers l’exemple du développement d’inhibiteurs de tyrosine kinase dans la leucémie myéloïde chronique et des premières immunothérapies dans les lymphomes B, cette revue montre les progrès réalisés. Par ailleurs, une meilleure compréhension de laphysiopathologie des diverses complications à l’origine des détresses vitales tels que le syndrome de lyse tumorale ou les syndromes de microangiopathie thrombotique a largement contribué à améliorer le devenir de ces patients en réanimation. Finalement, ces progrès suggèrent que la réanimation s’est intégrée comme un élément du parcours de soin de ces patients .Ils ont permis d’en évaluer le bien-fondé et de définir de nouveaux contrats d’admission permettant d’en optimiser le bénéfice

Overall prognosis of cancer or haematological has dramatically decreased over the last decades. Thus advances regarding cancer or haematological treatment, improved knowledge of usual complications and of their pathophysiology and changes in ICU admission policy and management are among factors which participated to the overall prognostic changes. Tyrosine-Kinase inhibitors in patients with chronic myeloid leukemia and anti-CD20 antibodies in patients with non-hodgkin’s lymphoma were among the first success of targeted therapies. These success stories have been followed by others and no less than 13 targeted therapies were available for cancer patients in December 2013. Additionally, pathophysiology of complication is better understood and prognostic impact of organ failure better apprehended. Standardized diagnostic criteria of tumor lysis syndrome along with improved understanding of short-term and long term influence of acute kidney injury (AKI) in this setting have led to specific management strategies focusing on prevention. In non-malignant haematological diseases, pathophysiological processes leading to thrombotic thrombocytopenic purpura or atypical haemolytic and uremic syndrome are now better understood leading to additional therapeutic options. Last, diversification of ICU admission policies may help in taking into account uncertainties, therapeutic advances and patients’ autonomy. This review will give an overview of these recent advances.