[Efficiency of protective isolation in allogeneic stem cell transplantation in children]

Area of Science:

• Pediatric Hematology
• Infectious Disease Control
• Transplantation Immunology

Background:

• Allogeneic hematopoietic stem cell transplantation (HSCT) in children with hematological malignancies requires stringent infection control.
• Standard protective isolation protocols aim to minimize infection risk but can be burdensome.
• Evaluating alternative infection control strategies is crucial for improving patient outcomes and feasibility.

Purpose of the Study:

• To compare the efficacy of an efficient protective isolation protocol versus standard protective isolation in pediatric HSCT recipients.
• To assess the impact of modified infection control on febrile index, a marker of infectious complications.

Main Methods:

• A cohort of 40 children with hematological malignancies undergoing allogeneic HSCT were divided into standard and efficient protective isolation groups.
• The efficient protocol included well-cooked foods and oral prophylaxis with new quinolones and antifungal drugs, suspending inhaled antibiotics/antifungals.
• The febrile index (febrile period > 38.5°C divided by days with neutrophil count < 500/µL) was compared between groups.

Main Results:

• No significant difference was observed in the febrile index between the efficient protective isolation group (0.25) and the standard group (0.38) (p = 0.08).
• This finding remained consistent regardless of the type of transplantation, with febrile indices of 0.36 and 0.38 for the respective groups (p = 0.14).

Conclusions:

• The efficient protective isolation procedure, incorporating dietary modifications and oral prophylaxis, is a feasible strategy in pediatric HSCT settings.
• This approach demonstrates comparable outcomes to standard isolation regarding infectious complications, suggesting potential for wider adoption.