ISOLATION WARD - THE FIRST 4 YEARS EXPERI ENCE

Since October 1988 there has been an isolation ward at Basle Cantonal Hospital. Its purpose is to treat patients with high dose chemotherapy and bone marrow transplantation under protective isolation and by sta ndardized criteria. The isolation ward has two sub-units, viz. the rev erse isolation for neutropenic patients (8 single room units) and the LAF unit (5 laminar airflow units) for allogeneic bone marrow transpla ntation (BMT). Up to July 1992, 287 patients (152 males and 133 female s) required 527 hospitalizations. The median age was 41 (5-82) years i n the reverse isolation unit and 28 (4-61) years in the LAF unit. Bed occupation was 90% and 82% throughout the period. 71% of patients were from the Basle area and the rest from elsewhere in Switzerland or fro m other countries. Diagnosis: acute leukemias (112); myelodysplastic o r myeloproliferative syndromes (52); severe aplastic anemia or agranul ocytosis (46); lymphoproliferative syndromes (50); solid tumors (28). Indications for hospitalisation: BMT (107); complications after BMT (i nfections, GvHD) (63); chemotherapy on protocols of SAKK (105); other chemotherapies (64); antilymphocyte globulin or growth factor treatmen t (27); splenectomies (18); neutropenic fever (62); patient work-up (5 9); terminal care (20). Patients in reverse isolation were hospitalize d for a median 17 (1-142) days; in the LAF unit for 52 (1-121) days. T he cumulative duration of hospitalization for chemotherapy for acute l eukemia (3 cycles of induction and consolidation treatment) is 79 (18- 149) days; for chemotherapy + BMT in first remission 129 (85-223) days . The length of hospitalization and the data concerning mortality show what kind of difficulties the team has to face. At the end of the obs ervation period 153 of the 287 patients were alive after a median obse rvation period of about 2 years; 65 died in the isolation ward. This o verview of the first 4 years of the isolation ward gives information a bout the number of patients and duration of hospitalization and provid es for better planning and an estimate of funding needs in the hospita l.