USE OF AN ISOLATOR SYSTEM IN CANCER CHEMOTHERAPY

A patient isolator system was employed to evaluate the effect of reduction of normal flora and of a relatively germ-free environment upon patients receiving myelosuppressive therapy. Twelve patients with a variety of malignancies underwent intensive chemotherapy within the isolator for a total of 537 days. The average period of occupancy was forty-five days. Almost all patients were considered treatment failures prior to therapy within the isolator. There were five patients with choriocarcinoma, four with acute leukemia and three with chronic myelogenous leukemia in blastic crisis. The antimicrobial regimen directed at reducing the patients' bacterial flora was reasonably effective and resulted in 60 per cent sterile stool cultures. The intensive chemotherapy administered resulted in granulocyte counts less than 500 per cu. mm. on 53 per cent of patient days. The incidence of infection was about 30 per cent of that which might have been expected outside the isolator. Observed infections included two gram-negative septicemias, one thrombophlebitis, one cellulitis and one case of multiple pulmonary abscesses. Of the five patients with choriocarcinoma, chorionic gonadotrophic hormone titer was reduced in three, unchanged in one and increased in one. All the patients with acute leukemia had remissions ranging from two to seven months with an average of five months. The three patients with chronic myelocytic leukemia showed no improvement. © 1968.