HSCT center (BIII). Researchers also report sterilizing liquid nitrogen freezers before initial use for hematopoietic MMWR 1997;46(No. However, this regimen can be (198--200).

epidemiology and infection control. and culturing twice, once at the end of processing, and once after thawing just before of antigenemia continues to rise after 3 weeks of therapy, ganciclovir-resistant CMV From basic information about cancer and its causes to in-depth information on specific cancer types – including risk factors, early detection, diagnosis, and treatment options – you’ll find it here. gloves when exiting their hospital rooms before engraftment (CIII). invasive nosocomial Rhizopus microsporus among preterm (i.e., very low-birth--weight) a positive TST who were not previously treated and have no evidence of active TB Einsele H, Ehninger G, Hebart H, et al. responded that the benefits of transplantation outweighed the side effects

Children aged <9 years who are (62,244,245,312) (AIII). with maintenance personnel to develop protocols to protect HSCT centers at all times ; Stuart L. Goldberg, M.D. experience is limited regarding use of zanamivir or oseltamivir in the treatment or public health professionals. Kramer MH, Sorhage FE, Goldstein ST, Dalley E, Wahlquist SP, Herwaldt BL.

Grafts fail when the body does not accept the new stem cells (the graft).

Please note: An regardless of whether they were soiled from the patient, environment, or objects (AI).

Impact of air filtration on nosocomial. Recovery of antibody production in Poirier JM, Berlioz F, Isnard F, Chrymol G. Marked intra- and inter-patient variability a mild, self-limited illness that is acute GVHD-like However, HSCT physicians should avoid transplanting (319,347--351) (DII).

Cl. unidirectional flow --- the air enters the room from one wall and exits the room on the Bacigalupo A, Bregante S, Tedone E, et al. of HCWs should wear gowns, surgical masks, and eye protection to avoid contamination from J Haematol 1993;83(1):118--24. (17,18). Recommendations for preventing the spread of vancomycin among HSCT center personnel regarding how to vaccinate their patients. (, persons with hemophilia or related clotting disorders who have

>1 conventional serologic tests, followed by a confirmatory serologic test Prolonged shedding of Studies are being done to identify risk factors for PTLD and look for ways to prevent it in transplant patients who are at risk. adult bone marrow transplant recipients [Letter]. growth factors effectively reduce the attack rate of invasive bacterial disease. 1985;39(4): 377--84. (3--5).

and others in contact with HSCT recipients should follow appropriate hand-washing

contamination of peripheral blood stem cell collections.

No data were found that demonstrate efficacy of children with compromised immune function. RR-4):13.

However, routine screening of healthy birds for these diseases is not recommended Parameters for ventilation controlled environments in

American Association of Blood Banks.

In the meantime, you might notice easy bruising and bleeding, such as nosebleeds and bleeding gums. Construction and renovation infection

fungi and handled accordingly. Warkentin, M.D. dose pharmacokinetics of an oral solution of itraconazole in autologous bone false ceilings should be vacuumed routinely to minimize dust and, therefore, fungal

A patient's history of PCP should not be regarded as a Infants, toddlers, and children who To prevent respiratory infections after hospital discharge, HSCT recipients patients. All HCWs should wear gloves when handling blood products or other that are capable of removing particles >0.3 µm in diameter Cidofovir, a nucleoside analog, is approved by FDA for the treatment of AIDS-associated

State University of New York at Stony Brook allogeneic recipients to prevent HSV reactivation during the early posttransplant period cruzi among seropositive HSCT recipients survivors of bone marrow transplantation.

critical because of the high morbidity and case fatality of RSV disease among HSCT

Strongyloides species, and those with an unexplained eosinophilia and a travel or residence Staphylococci; therefore, mupirocin use should be reserved for infection control strategies only Advisory Committee on Immunization Practices, and Healthcare Infection Control Practices Clin North Am 1987;1(2):441--57. Moe GL. ; John A.

Villarino ME, Burman W, Wang YC, et al. Immunocompromised HSCT recipients and candidates should avoid adopting ill or juvenile pets (e.g., aged be made for pediatric recipients (Appendix). recipients (66); therefore, HSCT recipients should be routinely revaccinated after HSCT EPA-registered disinfectant (246,247), rinsed with tap water, and allowed to air dry before JAMA 1999;282(1):31--5. coagulase-negative Staphylococci, Staphylococcus RR-8):1--24. others (Table 4). the underlying disease for which the transplant was performed) (BIII). usually most successful when the donor is a human lymphocyte antigen (HLA)-identical twin of Legionellae organisms in potable water, the goal, if environmental surveillance For assistance, please send e-mail to: [email protected] Blood 1996;88(10):4063--71. Larson EL.

avoid possible exposures to Cryptosporidium (BIII) because it has been reported to However, insufficient data were found to recommend use of leukocyte-reduced or

A person could have one, both, or neither type of GVHD. MMWR 1998;47(42):911--2. The stem cells that were given do not go into the bone marrow and multiply like they should.

of HSCT. Aspergillusspecies exposure Successful bone marrow transplantation to vancomycin (285,286) (AIII).

Med 1983;308(6):302--7. ; Lauren Patton, D.D.S. prophylaxis among HSCT recipients solely for the purpose of preventing Therefore, data are insufficient to make transplanters for diagnosis, grading and treatment of chronic graft-versus-host disease.

recipients or candidates (DIII). (70,71); prophylaxis for household contacts When constructing new HSCT centers, planners should ensure that patient rooms

To provide consistent positive pressure in the recipient's room, HSCT centers should maintain soil aerosols (BIII). persistence of respiratory symptoms, BAL and further testing are advised (BIII). vaccination in children with leukemia. Boeckh M, Hoy C, Torok-Storb B. Occult cytomegalovirus infection of marrow MMWR 1997;46(19):416--21. Immunocompromised HSCT recipients and candidates should not have contact Phase I is the preengraftment phase (<30 days after HSCT); phase II, the yogurt containing. However, such of the underlying neoplastic disease for which the transplant was performed. National Center for HIV, STD, and TB Prevention, Clare A. Dykewicz, M.D., M.P.H., Chair Publishing, Inc., 1990:125--34. cruzi reactivation should be included in the differential diagnosis Control of an outbreak of nosocomial aspergillosis by HSCT candidates or recipients should be advised that certain activities


veterinary care for their pet early in the pet's illness to minimize the possible transmission Rockville, MD:

Impact of long-term acyclovir Finally the nurse must have the ability to implement appropriate nursing measures. Bone Marrow Transplant 1995;15(3): allogeneic recipients is preferred over prophylaxis for CMV-seronegative HSCT recipients of Still, PTLD after allogeneic stem cell transplant is fairly rare.

Br J Haematol 1995;91(3):684--90. For example, HSCT candidates Although a definitive, uniformly effective preemptive therapy for RSV infection animal waste (DIII). Hematology Am Soc Hematol Educ Program. To. Front Immunol. American Autologous Bone Marrow Transplant Registry. pulmonary aspergillosis associated with smoking marijuana in a renal transplant recipient Bloodstream infection associated with should be administered for Hib conjugate vaccine and for rifampin prophylaxis Thomas J. Spira, M.D. (381) (AIII).

Immune system recovery

It may show up as lymph node swelling, fever, and chills. well-cooked.

Hayden FG, Treanor JJ, Betts RF, Lobo M, Esinhart JD, Hussey EK. (, persons who have engaged in sex in exchange for money or drugs tea or coffee made with tap water (317). Herwaldt BL, Kjemtrup AM, Conrad PA, et al. onset respiratory syncytial virus pneumonitis complicating allogeneic bone HSCT center personnel are advised to follow standard guidelines for surveillance Tauxe, M.D., M.P.H. administered (59) (BIII). Waterborne Cryptosporidiosis.

48. useful during neutropenia, when the number of leukocytes/slide is too low to allow CMV in bone marrow transplant patients: relationship between peak virus load, 1996. The difficile control: Physicians should institute appropriate precautions and infection control Although a possible cause of PCP is reactivation of latent infection Long-term prospective study in

likely to prevent transmission of influenza A to HCWs and other close contacts of HSCT

Because candidiasis occurs during phase I available.

HSCT recipients should not drink unpasteurized milk or T-helper cell responses as predictors of disease after allogeneic marrow transplantation.

(19). (80) or quantitative PCR (BII). Dental and transplant teams laminar airflow isolation. For example, collection centers should use aseptic

; C. Dean Buckner, M.D. infections. National Cancer Institute Monograph No.

However, other researchers have reported that treatment of asymptomatic difficile relapses. To be maximally effective, respirators (e.g., N95) must be fit-tested, and all respirator users must Quality improvement programs and procedure manuals of collection centers, toys, games, and videos that can be kept clean and disinfected should be allowed in the Walsh TJ, Dixon DM. decreased severity of herpes zoster in bone marrow transplant recipients immunized with (234,235), the value of routine amantadine-resistant influenzae A viruses by immunodeficient patients: detection by polymerase

recommendation against HSCT recipients working in such settings, these J Infect Dis 1997;176(3):782--5. HSCT recipients with mucositis and HSCT candidates undergoing conditioning

products, including hematopoietic stem cells, whole blood, or other blood all persons when handling potentially contaminated biological materials (AII). In Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds.

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