Critical care of the hematopoietic stem cell patient

As the indications for and volume of hematopoietic cell transplantation continue to expand, so do complications requiring critical care support. This article reviews the multidisciplinary approach to ICU management of complications in these patients. Unique aspects such as temporal sequence of complications caused by ablations and reconstitution of the immune system, graft-versus-host disease, regimen-related toxicity and engraftment syndrome are described, as well as organ-specific toxicities including pulmonary, gastroenterologic, neurologic, cardiac, hematologic, and renal complications. Prognostic indices are also addressed.