Clinical features of life-threatening complications following autologous stem cell transplantation in patients with lymphoma.

Toxic effects of high dose therapy (HDT) combined with autologous stem cell transplantation (ASCT) can lead to life-threatening conditions that may require intensive care unit (ICU) admission. We conducted a retrospective observational study over a 10-year period of all patients admitted to the ICU within 3 months after HDT/ASCT for lymphoma. Among the 532 patients treated by HDT/ASCT at our hospital, 27 (5%) were admitted to the ICU. Infections accounted for 88% (n = 24) of diagnoses, in whom 50% were microbiologically documented. Primary sources of infections were neutropenic enterocolitis (n = 9, 33%) and pneumonia (n = 9, 33%). Bacteria were identified in 83% of documented infections. ICU mortality was 18.5% (n = 5), representing 0.9% of the 532 patients. Among the 22 ICU survivors, 72.7% (n = 16) were alive and in complete remission 6 months after ICU discharge. In our experience, maximal intensive care support is justified for HDT/ASCT recipients with severe complications.