, Volume 49, Issue 5, pp 375–381 | Cite as

Laminar air flow versus barrier nursing in marrow transplant recipients

  • H. K. Mahmoud
  • U. W. Schaefer
  • F. Schüning
  • C. G. Schmidt
  • M. Bamberg
  • E. Haralambie
  • G. Linzenmeier
  • D. Hantschke
  • H. Grosse-Wilde
  • W. Luboldt
  • H. J. Richter
Original Articles


Forty-eight patients with acute leukaemia in relapse (n=14), acute leukaemia in complete remission (n=19), chronic myeloid leukaemia (n=8) or severe aplastic anaemia (n=7) received a marrow transplant. The first 26 patients were nursed in laminar-air-flow plastic isolators while the next 22 patients were treated in barrier nursing rooms. Gnotobiotic parameters and morbidity in the 2 groups are compared. Good decontamination of the gastro-intestinal tract was obtained using either of the 2 isolation techniques. The incidence of bacterial and mycotic infections, as well as the supportive care required by the patients was almost equal in both groups. Our results also suggest that the incidence of graft versus host disease may decrease with efficient decontamination of the patients.

Key words

Bone marrow transplantation Laminar air flow Barrier nursing Graft versus host disease 


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  1. 1.
    Baird-Parker AC (1972) Classification and identification of staphylococci and their resistance to physical agents. In: Cohen JE (ed) The staphylococci. Wiley, New York, p 1Google Scholar
  2. 2.
    Bekkum DW van, Vries MJ de, Waaij D van der (1967) Lesions characteristic of secondary disease in germfree heterologous radiation chimeras. J Natl Cancer Inst 38: 223–231Google Scholar
  3. 3.
    Bekkum DW van, Knaan S (1977) Role of bacterial microflora in development of intestinal lesions from graft-versus-host reaction. J Natl Cancer Inst 58: 787–790Google Scholar
  4. 4.
    Bekkum DW van, Roodenburg J, Heidt PJ, Waaij D van der (1974) Mitigation of secondary disease of allogeneic mouse radiation chimeras by modification of the intestinal microflora. J Natl Cancer Inst 52: 401–404Google Scholar
  5. 5.
    Buckner CD, Clift RA, Sanders JE, Meyers JD, Counts GW, Farewell VT, Thomas ED (1978) Protective environment for marrow transplant recipients. A prospective study. Ann Intern Med 89: 893–901Google Scholar
  6. 6.
    Buckner CD, Clift RA, Sanders JE, Thomas ED (1978) The role of a protective environment and prophylactic granulocyte transfusions in marrow transplantation. Transplant Proc 10: 255–257Google Scholar
  7. 7.
    Chüden H, Haralambie E, Linzenmeier G (1970) Der Einfluß von Amphotericin B auf den Candida-Befall der Mundhöhle und des Darmes bei Tetracyclin-Therapie. Mykosen 13: 13–17Google Scholar
  8. 8.
    Dankert J, Gaus W, Gaya H, Krieger D, Linzenmeier G, Waaij D van der (1978) Protective isolation and antimicrobial decontamination in patients with high susceptibility to infection. A prospective cooperative study of gnotobiotic care in acute leukaemia patients. III. The quality of isolation and decontamination. Infection 6: 175–191Google Scholar
  9. 9.
    Dietrich M, Gaus W, Vossen J, Waaij D van der, Wendt F (1977) Protective isolation and antimicrobial decontamination in patients with high susceptibility to infection. A prospective cooperative study of gnotobiotic care in acute leukaemia patients. I. Clinical results. Infection 5: 107–114Google Scholar
  10. 10.
    Essers L, Haralambie E (1977) Erfahrungen mit dem API 20A-Testsystem bei der Identifizierung von Anaerobiern aus der täglichen Routine. Zentralbl Bakteriol (Orig A) 238: 394–401Google Scholar
  11. 11.
    Haralambie E, Essers L (1977) Reicht das API 20A-Testsystem zur Differenzierung der in der Routine anfallenden anaeroben Spezies aus? Ärztl. Lab. 23: 317Google Scholar
  12. 12.
    Haralambie E, Linzenmeier G, Nowrousian MR, Schaefer UW, Schmidt, CG (1980) Gnotobiotische Untersuchungen — ein mikrobiologischer Beitrag zur Dekontamination von knochenmarktransplantierten Leukämiepatienten. Immun Infekt 8: 89–95Google Scholar
  13. 13.
    Heit H, Wilson R, Fliedner TM, Kohne E (1973) Mortality of secondary disease in antibiotic-treated mouse radiation chimeras. In: Heneghan JB (ed) Germfree research: biological effects of gnotobiotic environments. Academic Press, New York, pp 477–485Google Scholar
  14. 14.
    Jones JM, Wilson R, Bealmear PM (1971) Mortality and gross pathology of secondary disease in germfree mouse radiation chimeras. Radiat Res 45: 577–588Google Scholar
  15. 15.
    Kurrle E, Bhaduri S, Heimpel H, Hoelzer D, Krieger D, Vanek E, Kubanek B (1980) The efficiency of strict reverse isolation and antimicrobial decontamination in remission induction therapy of acute leukemia. Blut 40: 187–195Google Scholar
  16. 16.
    Linzenmeier G, Haralambie E, Dermouni H (1979) Kurzfristige orale Chemoprophylaxe vor Operationen am Darm. Aussagemöglichkeiten bei der quantitativen Untersuchung der Stuhlflora auf Bakterien und Pilze. Zentralbl Bakteriol (Orig A) 243: 326–335Google Scholar
  17. 17.
    Nowrousian MR, Schaefer UW, Schmidt CG, Haralambie E, Linzenmeier G, Hantschke D, Öhl S, Beyer JH (1979) Gnotobiotic results in bone marrow transplantation. In: Fliedner TM, Heit H, Niethammer D, Pflieger H (eds) Clinical and experimental gnotobiotics. Zentralbl Bakteriol [Suppl 7] G. Fischer, Stuttgart, New York, pp 275–279Google Scholar
  18. 18.
    Schaefer UW, Schüning F (1983) Knochenmarktransplantation am Westdeutschen Tumorzentrum Essen. In: Schmidt CG (ed): Aktuelle Probleme der Hämatologie und internistischen Onkologie. Präklinische und klinische Untersuchungen. Springer Berlin Heidelberg New York, pp 113–124Google Scholar
  19. 19.
    Schneider H, Haralambie E, Towfigh H, Eigler FW, Linzenmeier G (1976) Über die Wirksamkeit der Antibiotikavorbereitung in der Colonchirurgie. Chirurg 47: 33–38Google Scholar
  20. 20.
    Storb R, Prentice RL, Buckner CD, Clift RA, Appelbaum F, Deeg HJ, Doney K, Hansen JA, Mason M, Sanders JE, Singer J, Sullivan KE, Witherspoon RP, Thomas ED (1983) Graft-versus-host-disease and survival in patients with aplastic anemia treated by marrow grafts from HLA-identical siblings. Beneficial effect of a protective environment. N Engl J Med 308: 302–307Google Scholar
  21. 21.
    Storb R, Thomas ED (1983) Allogeneic bone marrow transplantation Immunological Rev 71: 77–102Google Scholar
  22. 22.
    Yates JW, Holland JF (1973) A controlled study of isolation and endogenous microbial suppression in acute myelocytic leukemia patients. Cancer 32: 1490–1498Google Scholar

Copyright information

© Springer-Verlag 1984

Authors and Affiliations

  • H. K. Mahmoud
    • 1
  • U. W. Schaefer
    • 1
  • F. Schüning
    • 1
  • C. G. Schmidt
    • 1
  • M. Bamberg
    • 2
  • E. Haralambie
    • 3
  • G. Linzenmeier
    • 3
  • D. Hantschke
    • 4
  • H. Grosse-Wilde
    • 5
  • W. Luboldt
    • 6
  • H. J. Richter
    • 7
  1. 1.Bone Marrow Transplantation Unit, Department of Internal Medicine (Tumor Research) West German Tumor CenterUniversity of EssenEssenFederal Republic of Germany
  2. 2.Department of RadiotherapyUniversity of EssenGermany
  3. 3.Department of MicrobiologyUniversity of EssenGermany
  4. 4.Department of DermatologyUniversity of EssenGermany
  5. 5.Department of ImmunogeneticsUniversity of EssenGermany
  6. 6.Department of Transfusion MedicineUniversity of EssenGermany
  7. 7.Department of PathologyUniversity of EssenGermany

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