Aims and objectives To establish the availability of High Efficiency Particulate Air (HEPA)‐ and non HEPA ‐filtered rooms in eastern E uropean transplant centres and to investigate the impact on incidence of pneumonia and mortality after haematopoietic stem cell transplantation ( HSCT ). Background Barrier nursing in HEPA ‐filtered rooms is generally recommended for patients undergoing HSCT . There are only limited data on the availability of HEPA ‐filtered rooms and the impact on incidence of pneumonia and mortality. Design A prospective, observational, international study. Methods Monitoring cards were distributed within the E ast F orum EBMT ‐ N urses G roup cooperating centres, and 689 consecutive patients were registered in 1/2010‐6/2012. Patients were monitored for 100 days post‐transplant. Results In patients undergoing autologous HSCT , pneumonia developed in 14/400 (3·5%) and was the cause of death in 2/14 (14%) of patients. There was no significant difference in mortality between HEPA ‐filtered and non HEPA ‐filtered groups (4·5% vs. 4·9%, respectively). 239/400 (59%) transplantations were performed in single‐bed rooms [190/239 (79%) HEPA ‐filtered] and 161 (41%) in two‐bed rooms [28/161 (17%) HEPA ‐filtered]. In allogeneic transplantation, pneumonia developed in 24/289 (8·3%) and was the cause of death in 11/24 (45%) of patients. There was no significant difference in mortality between HEPA ‐filtered and non‐ HEPA ‐filtered groups (14% vs. 17%, respectively). 281/289 (97%) of allogeneic transplantations were performed in single‐bed rooms [254/281 (90%) HEPA ‐filtered], and pneumonia was more frequent in patients on corticosteroids and in rooms without HEPA . Conclusion The incidence of pneumonia in the autologous transplantation setting is low. More pneumonia was observed in the allogeneic HSCT group, especially in patients on corticosteroids. There was a trend towards a lower incidence of pneumonia in allogeneic HSCT patients treated in HEPA ‐filtered rooms. Relevance to clinical practice Autologous HSCT transplantation may safely be performed without HEPA filtration. HEPA filtration might be preferable in patients undergoing allogeneic transplantation.

The East Forum EBMT Nurses Group (NG) consists of nurses and other healthcare professionals from Central and East Europe transplant centres in the EBMT Outreach countries. Recently, 23 transplant centres from 9 countries have cooperated. The Forum activities are in concordance with those of the EBMT-NG: to improve and promote quality and further development of haematopoietic stem cell transplantation nursing. Oral mucositis (OM) remains a significant medical and nursing problem in the high-dose chemotherapy and haematopoietic SCT setting. Recently, several evidence-based recommendations and guidelines on OM prophylaxis and care have been presented; for example, the MASCC (Multinational Association of Supportive Care in Cancer), NCCN (National Comprehensive Cancer Network) and ESMO (European Society for Medical Oncology).1, 2, 3, 4, 5 The East Forum has also acknowledged the importance of protocolized and evidence-based nursing and has promoted several research projects and discussions on nursing problems in an attempt to find an international consensus on some of these. The East Forum is aware of the importance of the EBMT Outreach countries’ multicentre cooperation, which can substantially help promote transplant nursing, nursing procedures and research. In October 2009, the Forum started discussions on OM care in an attempt to find an international consensus on minimum necessary and generally applicable management. The draft of the OM care Standard, which was based on the above-mentioned guidelines1, 2, 3, 4, 5 and clinical experience, comments of individual centres and the results of regional international trials,6 was presented to the Forum in March 2010 and later accepted. The Standard represents the minimum necessary care that should and can easily be provided to patients in every transplant centre within the East Forum. The use of chlorhexidine solutions is primarily not recommended for the treatment of OM or ulcerative OM. However, it can be used to help improve oral hygiene.3, 7 The goal of the Standard is to minimize the incidence, severity and complications associated with OM. The minimum requirements are: The authors declare no conflict of interest. Special thanks to the East Forum EBMT-NG cooperating nurses from Hradec Kralove, Plzen, Brno, Olomouc, Prague-Motol, Prague-VFN, Prague-Vinohrady and Prague-UHKT (Czech Republic), Debrecen (Hungary), Bucharest (Romania), Lublin, Bydgoszcz, Poznan, Gdansk, Lodz and Katowice (Poland), St Petersburg (Russia), Bratislava and Kosice (Slovakia), Tartu (Estonia), Ljubljana (Slovenia), Belgrade and Novi Sad (Serbia). Thanks are also due to Dr Vladimir Koza (Plzen, Czech Republic), the Co-Chair EBMT Outreach Committee and other members of the EBMT Outreach Committee.