The immunocompromised host.

Abstract

The immunocompromised patient, with or without superimposed granulocytopenia, provides a wide range of life-threatening challenges for the primary medical and nursing care management group. In the context of haematological malignancy, particularly leukaemia and bone marrow transplantation, special expertise needs to be developed which includes competence in many aspects of general medical, nursing, and intensive care techniques. Clearly, the range of essential knowledge extends to other disciplines including respiratory, cardiac, and renal medicine, with important contributions from microbiology, virology, dietetics and parenteral nutrition. The increasing cure rate achieved in haematological malignancy and the ever-widening indications for bone marrow transplantation require a dedicated and experienced group, able to handle all challenges. Integral to managing the complete patient, both through the acute phase and into periods of recovery and long-term rehabilitation, is inclusion of the paramedical specialists--social workers, occupational therapists, physical medicine physicians and physiotherapists. Proper balance in the cost-effective use of expertise from each of these groups and the provision of a suitable physical facility with protected environment and intensive care facilities are the cornerstones on which individual patient survival and ultimately increase in cure rates depend.