The predictive value for pulmonary infection by area over the neutrophil curve (D-index) in patients who underwent reduced intensity hematopoietic stem cell transplantation.

Abstract

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.

• Authors: Jun Aoki, Masaharu Tsubokura, Kazuhiko Kakihana, Gaku Oshikawa, Takeshi Kobayashi, Noriko Doki, Hisashi Sakamaki, Kazuteru Ohashi
• Journal: Pathology oncology research : POR (Pathol Oncol Res) Vol. 20 Issue 4 Pg. 879-83 (Oct 2014) ISSN: 1532-2807 [Electronic] Switzerland
• PMID: 24705712 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Female
• Follow-Up Studies
• Hematologic Neoplasms (complications, therapy)
• Hematopoietic Stem Cell Transplantation (adverse effects)
• Humans
• Lung Diseases, Fungal (blood, etiology, pathology)
• Male
• Middle Aged
• Neoplasm Staging
• Neutrophils (pathology)
• Prognosis
• ROC Curve
• Retrospective Studies
• Transplantation Conditioning (adverse effects)
• Young Adult