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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. [ABSTRACT FROM AUTHOR]

No data are available on outcomes of patients with lymphoma requiring intensive care unit (ICU) admission. We retrospectively studied 190 patients admitted to our ICU between 2000 and 2010, before or during the first chemotherapy course for lymphoma. Reasons for ICU admission were renal failure (36%), shock (28%), respiratory failure (26%), coma (22%) and monitoring (12%). Mechanical ventilation was needed in 45% of patients, dialysis in 41% and vasoactive drugs in 30%. ICU, hospital and 1-year mortality rates were 22%, 37% and 51%. By multivariate analysis, factors associated with higher hospital mortality were age > 50 years (odds ratio [OR], 2.23; 95% confidence interval [CI], 1.02-4.9), poor performance status (OR, 3.36; 95% CI, 1.47-6.54), high Sequential Organ Failure Assessment (SOFA) score (OR, 1.15/point; 95% CI, 1.04-1.27), hemophagocytic syndrome (OR, 2.57; 95% CI, 1.03-6.40), Burkitt lymphoma (OR, 3.36; 95% CI, 1.38-8.19) and primary cerebral lymphoma (OR, 7.32; 95% CI, 1.06-50.54). Admission after 2004 was associated with better survival (OR, 0.35; 95% CI, 0.15-0.78). [ABSTRACT FROM AUTHOR]