Comparison of neutropenia profiles in different treatment protocols for acute myeloid leukemia using the D-index


Neutropenia is a major risk factor for opportunistic infections in patients with acute myeloid leukemia (AML) who undergo chemotherapy. In the present study, we retrospectively compared the D-index, which reflects both the depth and duration of neutropenia, between two different chemotherapy regimens for AML. Sixty-seven patients with AML were included: 37 received an induction regimen of daunorubicin (DNR) and cytarabine followed by consolidation therapies consisting of standard-dose cytarabine (SDAC) and other antineoplastic agents; the remaining 30 received idarubicin (IDR) and cytarabine as remission induction therapy followed by high-dose cytarabine (HDAC). The duration of neutropenia was shorter, but the D-index was higher, with IDR than with DNR. The total D-index during the entire consolidation therapies was significantly higher with SDAC than with HDAC. In conclusion, the neutropenia profile differs between treatment regimens, and thus, physicians should plan the management of infectious complications according to the neutropenia profile for each regimen.

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We thank the patients for their participation in the study.

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YK contributed to the study design, data analysis, and manuscript preparation. SK, HN, KM, YS, SK, YT, SO, TN, DM, RY, KM, MA, CY, KH, KS, IO, SF, KO, SK, KM and YK reviewed the manuscript.

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Correspondence to Yoshinobu Kanda.

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Kawasaki, Y., Kimura, S., Nakano, H. et al. Comparison of neutropenia profiles in different treatment protocols for acute myeloid leukemia using the D-index. Int J Hematol 109, 470–476 (2019).

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  • D-index
  • Acute myeloid leukemia
  • Neutropenia
  • Anthracycline
  • High-dose cytarabine