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Retrospective evaluation of the area over the neutrophil curve index to predict early infection in hematopoietic stem cell transplantation recipients.
- Source :
-
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation [Biol Blood Marrow Transplant] 2010 Oct; Vol. 16 (10), pp. 1355-61. Date of Electronic Publication: 2010 May 10. - Publication Year :
- 2010
-
Abstract
- We investigated the impact of neutropenia on the development of early bloodstream and pulmonary infections in hematopoietic stem cell transplantation (HSCT) recipients, and evaluated the utility of an index (D-index) that reflects both the intensity and duration of neutropenia. Fifty-eight patients (23 autologous, 35 allogeneic HSCT recipients) were enrolled in this retrospective study. The D-index was defined as the area over the neutrophil curve during neutropenia. We also evaluated the utility of the cumulative D-index from the start of neutropenia until the development of infection (c-D-index), which may enable real-time assessment of the risk for infection. The patients showed 12 and 7 episodes of bloodstream and pulmonary infection, respectively. The D-index, days of neutropenia (<500/microL) and days of profound neutropenia (<100/microL) had at least a nearly significant impact on the development of both bloodstream and pulmonary infections. On the other hand, the c-D-index, cumulative days of neutropenia, and cumulative days of profound neutropenia significantly affected pulmonary infection, but not bloodstream infection. The c-D-index had a high negative predictive value of 97.4% for pulmonary infection with a cutoff of 5500, but the area under the receiver operating characteristic curve was similar to that of the cumulative days of neutropenia and profound neutropenia. Our results showed that although the c-D-index may be useful for identifying patients who are at low risk for early pulmonary infection after HSCT, its performance was similar to that of the simple duration of neutropenia.<br /> (Copyright © 2010 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Adult
Anti-Bacterial Agents therapeutic use
Antibiotic Prophylaxis
Antifungal Agents therapeutic use
Bacteremia drug therapy
Bacteremia etiology
Female
Fungemia blood
Fungemia drug therapy
Fungemia etiology
Hematologic Neoplasms complications
Hematologic Neoplasms surgery
Humans
Immunocompromised Host
Lung Diseases, Fungal drug therapy
Lung Diseases, Fungal etiology
Male
Middle Aged
Myelodysplastic Syndromes complications
Myelodysplastic Syndromes surgery
Neutropenia chemically induced
Pneumonia, Bacterial drug therapy
Pneumonia, Bacterial etiology
Retrospective Studies
Time Factors
Transplantation Conditioning adverse effects
Young Adult
Area Under Curve
Bacteremia blood
Hematopoietic Stem Cell Transplantation
Leukocyte Count
Lung Diseases, Fungal blood
Neutropenia complications
Neutrophils
Pneumonia, Bacterial blood
Postoperative Complications blood
Subjects
Details
- Language :
- English
- ISSN :
- 1523-6536
- Volume :
- 16
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 20457267
- Full Text :
- https://doi.org/10.1016/j.bbmt.2010.04.012