A 34-year-old man suffering from Hodgkin's disease underwent high-dose chemotherapy (CBV) followed by transplantation of autologous peripheral blood stem cells. On day +6 after peripheral blood stem cell transplant (PBSCT) bacterial pneumonia developed. Along with rapid engraftment during stimulation with G-CSF adult respiratory distress syndrome (ARDS) developed within 4 days. High-flow CPAP (continuous positive airway pressure) ventilation via a sealed face-mask was initiated. The patient tolerated the sealed face-mask very well, and CPAP was continuously administered for 4 days, thus avoiding intubation. High-flow CPAP may offer a therapeutic alternative in selected patients with respiratory compromise after PBSCT.