title: Granulocyte-colony stimulating factor response is superior to neutropenia duration in predicting the risk of infection after high-dose chemotherapy for myeloma and lymphoma.
abstract: The patient granulocyte-colony stimulating factor (G-CSF) response is represented by the leukocyte peak in the blood induced by a single dose of G-CSF after chemotherapy, and is correlated with subsequent neutropenic infection risk. General patterns for a meaningful risk group stratification, have not yet been determined. Two independent data sets including a total of 306 cases with myeloma or lymphoma and autologous blood stem cell transplant were available. An infection susceptibility curve plotted according to ranked G-CSF responses from a multicenter study reproduced and validated a curve from the previous single center. Two trend changes were seen within these curves at around 11,000 and 22,000 leukocytes/μL, which separated three groups with a high, medium and low risk of infection. While G-CSF response is related to the consecutive duration of neutropenia, it retains additional independent predictive information for infection risk (p<0.0001) and, more important, is a tool available before the onset of the critical period.
authors.affiliation: Schön Klinik Starnberger See , Berg , Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Straka
authors.forename: Hans
authors.initials: H
authors.lastname: Salwender
authors.forename: Brigitte
authors.initials: B
authors.lastname: Schnabel
authors.forename: Michael
authors.initials: M
authors.lastname: Sandherr
authors.forename: Hannes
authors.initials: H
authors.lastname: Wandt
authors.forename: Kai
authors.initials: K
authors.lastname: Hübel
authors.forename: Christof
authors.initials: C
authors.lastname: Scheid
authors.forename: Bernd
authors.initials: B
authors.lastname: Metzner
authors.forename: Marcus
authors.initials: M
authors.lastname: Hentrich
authors.forename: Daniel
authors.initials: D
authors.lastname: Franke
authors.forename: Gloria
authors.initials: G
authors.lastname: Weidenegger
authors.forename: Mathias
authors.initials: M
authors.lastname: Freund
authors.forename: Orhan
authors.initials: O
authors.lastname: Sezer
authors.forename: Hermann
authors.initials: H
authors.lastname: Einsele
authors.forename: Axel
authors.initials: A
authors.lastname: Hinke
authors.forename: Bertold
authors.initials: B
authors.lastname: Emmerich
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000209:etiology / Q000517:prevention & control; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007958:Leukocyte Count; D016014:Linear Models; D008223:Lymphoma / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy*; D015999:Multivariate Analysis; D009181:Mycoses / Q000209:etiology / Q000517:prevention & control; D009503:Neutropenia / Q000209:etiology / Q000517:prevention & control*; D012307:Risk Factors; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D016179:Granulocyte Colony-Stimulating Factor
keywords: G-CSF; autologous transplant; lymphoma; multiple myeloma; neutropenic infection