Fig 1.
Definitions of the four indices investigated.
The D-index, total D-index, cumulative D-index (c-D-index), and total c-D-index are depicted on the neutrophil count curve for a patient undergoing induction therapy and three periods of consolidation therapy. FN, febrile neutropenia.
Fig 2.
We gathered 51 patients treated for acute myeloid leukemia at our institute. In total, 171 neutropenic events, of which 115 febrile neutropenia episodes were comorbid, were used in our study.
Table 1.
Patient characteristics.
Fig 3.
Comparison of the D-index and the c-D-index in patients with and without febrile neutropenia (FN).
(a) The D-index was significantly higher in patients with FN (P < 0.001). (b) The c-D-index on day 11 (c-D11-index) was significantly lower in patients with FN (P < 0.001). *Statistically significant (P < 0.001).
Fig 4.
Sensitivity and specificity validation analysis on receiver operating characteristics (ROC) curve.
ROC analysis defined a c-D11-index of 718 as the best cutoff value to discriminate between patients who develop FN after day 11 and those who do not. The sensitivity and specificity of ROC curve analysis were 68.5% and 68.4%, respectively.
Fig 5.
Cumulative incidence of febrile neutropenia (FN) according to defined c-D11-index value.
The cumulative incidence of FN was significantly higher in the group with c-D11-index ≥710 (77.2%) than in the group with c-D11-index <710 (41.2%) (P < 0.001). *Statistically significant.
Table 2.
Risk factors for the onset of febrile neutropenia.