1670. D-index: the evaluation of the area over the neutrophil curve for predicting invasive mold infections
Session: Poster Abstract Session: Pre-emptive Therapy in Transplantation and Immunocompromised Hosts
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Background: Neutropenia is a critical risk factor for invasive mold infections (IMIs). We retrospectively performed this study to assess the performance of D-index, the new test that combines both the duration and the severity of neutropenia, in predicting IMIs among patients with acute myelogenous leukemia (AML).

Methods: Fifteen  patients with IMI and 28 patients who did not develop IMI were enrolled in the study. The D-index was defined as the  area over the neutrophil curve where as cumulative-D-index (c-D-index) was the area over the neutrophil curve from the start of neutropenia until the first clinical manifestation of IMIs.

Results: The D-index and the c-D-index tended to be significantly higher in patients with IFI with the median of 10150 (4000-22000) and 5300 (2300-22200), respectively (p=0.037 and p=0.003, respectively). The ROC analyses showed that a cutoff point of 3875 for the D-index in predicting IFI; the sensitivity, specificity, positive and negative predictive values were 100%, 67.9%, 35.4% and 100%, respectively. A cutoff point of 4225 for the c-D-index in predicting IFI; the sensitivity, specificity, positive and negative predictive values for c-D-index were 93.3%, 71.4%, 36.6% and 98.4 %.

Conclusion: The D-index, especially the c-D-index, could be a useful tool with its high negative predictive value to exclude as well as to predict IFI in daily management of neutropenic patients.

Gülden Yilmaz1, Belgİn Coskun2, Atİlla Elhan3, Alpay Azap1 and Hamdi Akan4, (1)Ankara University, Faculty of Medicine, Department of Clinical Microbiology and Infectious Disease, ANKARA, Turkey, (2)Ankara University, Faculty of Medicine, Department of Clinical Microbiology and Infectious Disease,, ANKARA, Turkey, (3)Ankara University, Faculty of Medicine, Department of Biostatistics, ANKARA, Turkey, (4)Ankara University, Faculty of Medicine, Department of Hematology, ANKARA, Turkey

Disclosures:

G. Yilmaz, None

B. Coskun, None

A. Elhan, None

A. Azap, None

H. Akan, None

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