1. Granulocyte-colony stimulating factor response is superior to neutropenia duration in predicting the risk of infection after high-dose chemotherapy for myeloma and lymphoma.
- Author
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Straka C, Salwender H, Schnabel B, Sandherr M, Wandt H, Hübel K, Scheid C, Metzner B, Hentrich M, Franke D, Weidenegger G, Freund M, Sezer O, Einsele H, Hinke A, and Emmerich B
- Subjects
- Adult, Antineoplastic Combined Chemotherapy Protocols adverse effects, Bacterial Infections etiology, Bacterial Infections prevention & control, Combined Modality Therapy, Dose-Response Relationship, Drug, Female, Hematopoietic Stem Cell Transplantation adverse effects, Humans, Leukocyte Count, Linear Models, Male, Middle Aged, Multivariate Analysis, Mycoses etiology, Mycoses prevention & control, Neutropenia etiology, Risk Factors, Time Factors, Transplantation, Autologous, Treatment Outcome, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Granulocyte Colony-Stimulating Factor therapeutic use, Hematopoietic Stem Cell Transplantation methods, Lymphoma therapy, Multiple Myeloma therapy, Neutropenia prevention & control
- 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.
- Published
- 2015
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