title: Clinical features of life-threatening complications following autologous stem cell transplantation in patients with lymphoma.
abstract: 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.
authors: a Medical Intensive Care Unit, Saint Louis University Hospital , Paris , France.
authors: Lionel
authors: L
authors: Kerhuel
authors: b Hematology-Oncology Department, Saint Louis University Hospital , Paris , France.
authors: Sandy
authors: S
authors: Amorim
authors: a Medical Intensive Care Unit, Saint Louis University Hospital , Paris , France.|c Paris Diderot University, Sorbonne Paris Cité , Paris , France.
authors: Elie
authors: E
authors: Azoulay
authors: b Hematology-Oncology Department, Saint Louis University Hospital , Paris , France.
authors: Catherine
authors: C
authors: Thiéblemont
authors: a Medical Intensive Care Unit, Saint Louis University Hospital , Paris , France.
authors: Emmanuel
authors: E
authors: Canet
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D003422:Critical Care / Q000706:statistics & numerical data; D016638:Critical Illness / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D019468:Disease Management; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008223:Lymphoma / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous
keywords: Autologous stem cell transplantation; intensive care unit; lymphoma; mortality