The predictive value for pulmonary infection by area over the neutrophil curve (D-index) in patients who underwent reduced intensity hematopoietic stem cell transplantation.
We evaluated the predictive value of the D-index for pulmonary infection in the early phase of reduced intensity stem cell transplantation (RIST). Out of 68 patients, ten patients developed a pulmonary infection within 100 days after RIST. Both the D-index and the cD-index were higher in the patients with pulmonary infection than in the control group (P = 0.009, P = 0.042, respectively). The best sensitivity and specificity, calculated with receiver operating characteristic curves, showed that the D-index was superior to the duration of neutropenia in predicting pulmonary infection. We also evaluated the utility of a cumulative D-index until 21 days after RIST (D21-index). The D21-index was higher in the patients with pulmonary infection (P = 0.047). The cutoff value of the D21-index was lower than that of the D-index (8650 vs. 11000) with comparable sensitivity and specificity. Our results demonstrate that the D21-index, as well as the D-index, are useful tools for the prediction of pulmonary infection in RIST.
Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan.
Jun
J
Aoki
Masaharu
M
Tsubokura
Kazuhiko
K
Kakihana
Gaku
G
Oshikawa
Takeshi
T
Kobayashi
Noriko
N
Doki
Hisashi
H
Sakamaki
Kazuteru
K
Ohashi
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D019337:Hematologic Neoplasms / Q000150:complications* / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008172:Lung Diseases, Fungal / Q000097:blood* / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009504:Neutrophils / Q000473:pathology*; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D019172:Transplantation Conditioning / Q000009:adverse effects*; D055815:Young Adult