title: D-index dose not predict the development of pulmonary infection in acute myeloid leukemia patients undergoing consolidation chemotherapy with high-dose cytarabine.
abstract: The D-index is calculated as the area over the neutrophil curve during neutropenia. We investigated the impact of the D-index on pulmonary infection in 33 acute myeloid leukemia patients undergoing consolidation chemotherapy with high-dose cytarabine. There was no difference in the D-index between chemotherapies with and without pulmonary infection. The cumulative D-index (c-D-index) until the development of infection exceeded 4000 in four of five patients with pulmonary infection. Although there was no difference in the total D-index throughout the overall consolidation chemotherapy, the total D-index from induction to consolidation and the D-index at induction chemotherapy were higher in patients with pulmonary infection during consolidation than in those without it (P = 0.014 and 0.019, respectively). Our results showed that the cumulative effect of neutropenia might determine the risk of pulmonary infection in consolidation chemotherapy. We are planning a clinical trial of c-D-index-guided preemptive antifungal therapy.
authors.forename: Shun-ichi
authors.initials: S
authors.lastname: Kimura
authors.forename: Hidenori
authors.initials: H
authors.lastname: Wada
authors.forename: Yuko
authors.initials: Y
authors.lastname: Ishihara
authors.forename: Koji
authors.initials: K
authors.lastname: Kawamura
authors.forename: Kana
authors.initials: K
authors.lastname: Sakamoto
authors.forename: Ryoko
authors.initials: R
authors.lastname: Yamasaki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ashizawa
authors.forename: Tomohito
authors.initials: T
authors.lastname: Machishima
authors.forename: Miki
authors.initials: M
authors.lastname: Sato
authors.forename: Kiriko
authors.initials: K
authors.lastname: Terasako
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakasone
authors.forename: Misato
authors.initials: M
authors.lastname: Kikuchi
authors.forename: Shinya
authors.initials: S
authors.lastname: Okuda
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kako
authors.forename: Junya
authors.initials: J
authors.lastname: Kanda
authors.forename: Rie
authors.initials: R
authors.lastname: Yamazaki
authors.forename: Aki
authors.initials: A
authors.lastname: Tanihara
authors.forename: Junji
authors.initials: J
authors.lastname: Nishida
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kanda
mesh_terms: D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D060830:Consolidation Chemotherapy; D003561:Cytarabine / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000097:blood / Q000188:drug therapy* / Q000382:microbiology*; D008171:Lung Diseases / Q000097:blood* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage; D009503:Neutropenia / Q000139:chemically induced / Q000382:microbiology; D009504:Neutrophils / Q000378:metabolism / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000964:Antimetabolites, Antineoplastic; D003561:Cytarabine; D008942:Mitoxantrone
keywords: Acute myeloid leukemia; D-index; High-dose cytarabine; Neutropenia; Pulmonary infection