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Related Experiment Videos

Bone marrow transplantation in childhood leukemia using reverse isolation techniques.

A K Ogden1, C P Steuber, D H Mahoney

  • 1Department of Pediatrics, Baylor College of Medicine, Houston, TX.

Medical and Pediatric Oncology
|January 1, 1990
PubMed
Summary

Pediatric bone marrow transplants using standard reverse isolation showed infection and graft-versus-host disease rates comparable to strict protocols. This suggests bone marrow transplantation can be performed safely without intensive isolation measures.

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Area of Science:

  • Hematology
  • Oncology
  • Infectious Disease

Background:

  • Bone marrow transplantation (BMT) is a critical treatment for pediatric hematologic malignancies.
  • Historically, intensive isolation techniques were employed to minimize infection and graft-versus-host disease (GVHD) risks.
  • The necessity of stringent protocols versus standard isolation in BMT remains an area of investigation.

Purpose of the Study:

  • To evaluate the outcomes of pediatric BMT performed with routine reverse isolation.
  • To compare infection and GVHD rates in patients not utilizing laminar air flow, prophylactic antibiotics, or gut sterilization.
  • To determine if standard isolation is sufficient for safe pediatric BMT.

Main Methods:

  • Retrospective analysis of 29 pediatric patients undergoing BMT between 1979 and 1986.

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  • Patients received care under routine reverse isolation protocols.
  • Exclusion of laminar air flow rooms, prophylactic antibiotics, and gut sterilization.

    • Main Results:

    • 16 patients with acute lymphocytic leukemia (ALL), 10 with acute nonlymphocytic leukemia (ANLL), and 3 with chronic myelogenous leukemia (CML) were included.
    • A bacteremia rate of 37.9% (11 episodes in 7 patients) was observed.
    • Moderate-to-severe acute graft-versus-host disease (GVHD) occurred in 27.6% (8 patients).

    Conclusions:

    • The incidence of infection and GVHD within 100 days post-BMT was comparable to published data from centers using rigid isolation.
    • Pediatric bone marrow transplantation can potentially be performed safely using standard reverse isolation.
    • These findings suggest that intensive isolation and gut sterilization may not be essential for all BMT procedures, potentially reducing patient burden and resource utilization.