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c-D-index at day 11 can predict febrile neutropenia during chemotherapy in acute myeloid leukemia

Acute myeloid leukemia (AML) often requires long-term intensive chemotherapy for its cure. During chemotherapy, the patient always experiences neutropenia with readings below 500 cells/μL; this is often accompanied by pyrexia with a temperature of more than 101°F. This combination of neutropenia and...

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Autores principales: Kubo, Hiroyuki, Imataki, Osamu, Kubo, Yukiko Hamasaki, Uemura, Makiko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8929597/
https://www.ncbi.nlm.nih.gov/pubmed/35298471
http://dx.doi.org/10.1371/journal.pone.0263623
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author Kubo, Hiroyuki
Imataki, Osamu
Kubo, Yukiko Hamasaki
Uemura, Makiko
author_facet Kubo, Hiroyuki
Imataki, Osamu
Kubo, Yukiko Hamasaki
Uemura, Makiko
author_sort Kubo, Hiroyuki
collection PubMed
description Acute myeloid leukemia (AML) often requires long-term intensive chemotherapy for its cure. During chemotherapy, the patient always experiences neutropenia with readings below 500 cells/μL; this is often accompanied by pyrexia with a temperature of more than 101°F. This combination of neutropenia and fever is called febrile neutropenia (FN). A tool to sum up the daily severity of a patient’s neutropenia, the “D-index,” has been validated in some specific clinical settings. In this study, we examined whether the D-index is a useful predictor of the onset of FN. We recruited consecutive patients treated with induction and consolidation chemotherapy for newly diagnosed AML. We gathered all the FN events and their clinical background data retrospectively. Patients’ background, such as pre-existing conditions and disease status before the treatment, were analyzed using multivariate methods. All FN events during chemotherapy were evaluated for infection focus and causative organism. A total cohort of 51 cases (25 women, 26 men; median age 51 years, range 18–74) was analyzed. They displayed 171 neutropenic events (115 FN and 56 afebrile episodes) during chemotherapy, and complete neutropenic events were used in this study. Sensitivity and specificity analysis showed that the most useful cutoff value to predict the onset of FN was a cumulative D-index at day 11 (c-D11-index) of 718. The cumulative incidence of FN during chemotherapy was significantly higher in the group with c-D11-index ≥710 (80%) than in the group with c-D11-index <710 (39%) (P < 0.0001). Through multivariate analysis, the presence of diabetes mellitus and the c-D11-index were extracted as contributing factors to the onset of FN (P = 0.0087 and 0.0002, respectively). In conclusion, we can predict that AML patients receiving chemotherapy will experience the complication of FN when the c-D-index at day 11 is >710, with an odds ratio of 2.1.
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spelling pubmed-89295972022-03-18 c-D-index at day 11 can predict febrile neutropenia during chemotherapy in acute myeloid leukemia Kubo, Hiroyuki Imataki, Osamu Kubo, Yukiko Hamasaki Uemura, Makiko PLoS One Research Article Acute myeloid leukemia (AML) often requires long-term intensive chemotherapy for its cure. During chemotherapy, the patient always experiences neutropenia with readings below 500 cells/μL; this is often accompanied by pyrexia with a temperature of more than 101°F. This combination of neutropenia and fever is called febrile neutropenia (FN). A tool to sum up the daily severity of a patient’s neutropenia, the “D-index,” has been validated in some specific clinical settings. In this study, we examined whether the D-index is a useful predictor of the onset of FN. We recruited consecutive patients treated with induction and consolidation chemotherapy for newly diagnosed AML. We gathered all the FN events and their clinical background data retrospectively. Patients’ background, such as pre-existing conditions and disease status before the treatment, were analyzed using multivariate methods. All FN events during chemotherapy were evaluated for infection focus and causative organism. A total cohort of 51 cases (25 women, 26 men; median age 51 years, range 18–74) was analyzed. They displayed 171 neutropenic events (115 FN and 56 afebrile episodes) during chemotherapy, and complete neutropenic events were used in this study. Sensitivity and specificity analysis showed that the most useful cutoff value to predict the onset of FN was a cumulative D-index at day 11 (c-D11-index) of 718. The cumulative incidence of FN during chemotherapy was significantly higher in the group with c-D11-index ≥710 (80%) than in the group with c-D11-index <710 (39%) (P < 0.0001). Through multivariate analysis, the presence of diabetes mellitus and the c-D11-index were extracted as contributing factors to the onset of FN (P = 0.0087 and 0.0002, respectively). In conclusion, we can predict that AML patients receiving chemotherapy will experience the complication of FN when the c-D-index at day 11 is >710, with an odds ratio of 2.1. Public Library of Science 2022-03-17 /pmc/articles/PMC8929597/ /pubmed/35298471 http://dx.doi.org/10.1371/journal.pone.0263623 Text en © 2022 Kubo et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Kubo, Hiroyuki
Imataki, Osamu
Kubo, Yukiko Hamasaki
Uemura, Makiko
c-D-index at day 11 can predict febrile neutropenia during chemotherapy in acute myeloid leukemia
title c-D-index at day 11 can predict febrile neutropenia during chemotherapy in acute myeloid leukemia
title_full c-D-index at day 11 can predict febrile neutropenia during chemotherapy in acute myeloid leukemia
title_fullStr c-D-index at day 11 can predict febrile neutropenia during chemotherapy in acute myeloid leukemia
title_full_unstemmed c-D-index at day 11 can predict febrile neutropenia during chemotherapy in acute myeloid leukemia
title_short c-D-index at day 11 can predict febrile neutropenia during chemotherapy in acute myeloid leukemia
title_sort c-d-index at day 11 can predict febrile neutropenia during chemotherapy in acute myeloid leukemia
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8929597/
https://www.ncbi.nlm.nih.gov/pubmed/35298471
http://dx.doi.org/10.1371/journal.pone.0263623
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