D-index dose not predict the development of pulmonary infection in acute myeloid leukemia patients undergoing consolidation chemotherapy with high-dose cytarabine

Shun Ichi Kimura, Hidenori Wada, Yuko Ishihara, Koji Kawamura, Kana Sakamoto, Ryoko Yamasaki, Masahiro Ashizawa, Tomohito Machishima, Miki Sato, Kiriko Terasako, Hideki Nakasone, Misato Kikuchi, Shinya Okuda, Shinichi Kako, Junya Kanda, Rie Yamazaki, Aki Tanihara, Junji Nishida, Yoshinobu Kanda

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8 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)107-112
Number of pages6
JournalHematology
Volume19
Issue number2
DOIs
Publication statusPublished - 2014 Mar

Keywords

  • Acute myeloid leukemia
  • D-index
  • High-dose cytarabine
  • Neutropenia
  • Pulmonary infection

ASJC Scopus subject areas

  • Hematology

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    Kimura, S. I., Wada, H., Ishihara, Y., Kawamura, K., Sakamoto, K., Yamasaki, R., Ashizawa, M., Machishima, T., Sato, M., Terasako, K., Nakasone, H., Kikuchi, M., Okuda, S., Kako, S., Kanda, J., Yamazaki, R., Tanihara, A., Nishida, J., & Kanda, Y. (2014). D-index dose not predict the development of pulmonary infection in acute myeloid leukemia patients undergoing consolidation chemotherapy with high-dose cytarabine. Hematology, 19(2), 107-112. https://doi.org/10.1179/1607845413Y.0000000103