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10 - Preventative care

Published online by Cambridge University Press:  05 November 2013

Joseph H. Antin
Affiliation:
Dana-Farber Cancer Institute, Boston
Deborah Yolin Raley
Affiliation:
Dana-Farber Cancer Institute, Boston
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Summary

Preventative care will vary onthe basis of transplant type, institutional guidelines, protocol,medications, and pretransplant viral studies.

Infection prophylaxis

Please see Chapter 18 oninfectious diseases.

Hospital infection control

Hospital personnel shouldfollow standard infection control and Center for Disease Control (CDC)guidelines to prevent nosocomial infections. The efficacy of differenttransplant-specific precautions in preventing nosocomial infections has notbeen studied. Hand washing continues to be the single most critical and efective procedure for preventing infection. If gloves are utilized, theyshould be changed between patients. All equipment should be sterilized ordisinfected and Environment Protection Agency (EPA) registered.

Allogeneic hematopoietic stemcell transplantation (HSCT) patients should be placed in private rooms thathave >12 air exchanges per hour and high-efficiency particulate airfilters (HEPA) that are capable of removing particles ≥0.3 μm in diameter.It is generally considered good practice to treat all immunocompromisedpeople in HEPA-filtered rooms, although the data are less clear forautologous HSCT than for allogeneic HSCT.

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Chapter
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Publisher: Cambridge University Press
Print publication year: 2013

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References

Centers for Disease Control and Prevention. General recommendations on immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 2011; 60: 1–64.
Guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients. MMWR 2000; 49: rr-10: 1–128.
Hilgendorf, I, Freund, M, Jilg, W, et al. Vaccination of allogeneic haematopoietic stem cell transplant recipients: report from the international consensus conference on clinical practice in chronic GVHD. Vaccine 2011; 29: 2825–33.CrossRefGoogle ScholarPubMed
Ljungman, P, Cordonnier, C, Einsele, H, et al. Vaccination of hematopoietic cell transplant recipients. Bone Marrow Transplant 2009; 44: 521–6.CrossRefGoogle ScholarPubMed
Tomblyn, M, Chiller, T, Einsele, H, et al. Guidelines for preventing infectious complications among hematopoietic cell transplantation recipients: a global perspective. Biol Blood Marrow Transplant 2009; 15: 1143–238.CrossRefGoogle ScholarPubMed

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