• Nathan Cantoni, Maja Weisser, Andreas Buser, Caroline Arber, Martin Stern, Dominik Heim, Jörg Halter, Susanne Christen, Dimitrios A Tsakiris, Armin Droll, Reno Frei, Andreas F Widmer, Ursula Flückiger, Jakob Passweg, André Tichelli, and Alois Gratwohl.
• Division of Hematology, University Hospital Basel, Basel, Switzerland.
• Eur. J. Haematol. 2009 Aug 1; 83 (2): 130-8.

ObjectiveNursing in 'live islands' and routine high dose intravenous immunoglobulins after allogeneic hematopoietic stem cell transplantation were abandoned by many teams in view of limited evidence and high costs.MethodsThis retrospective single-center study examines the impact of change from nursing in 'live islands' to care in single rooms (SR) and from high dose to targeted intravenous immunoglobulins (IVIG) on mortality and infection rate of adult patients receiving an allogeneic stem cell or bone marrow transplantation in two steps and three time cohorts (1993-1997, 1997-2000, 2000-2003).ResultsTwo hundred forty-eight allogeneic hematopoetic stem cell transplantations were performed in 227 patients. Patient characteristics were comparable in the three cohorts for gender, median age, underlying disease, and disease stage, prophylaxis for graft versus host disease (GvHD) and cytomegalovirus constellation. The incidence of infections (78.4%) and infection rates remained stable (rates/1000 days of neutropenia for sepsis 17.61, for pneumonia 6.76). Cumulative incidence of GvHD and transplant-related mortality did not change over time.ConclusionsChange from nursing in 'live islands' to SR and reduction of high dose to targeted IVIG did not result in increased infection rates or mortality despite an increase in patient age. These results support the current practice.

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