Table 2.
Univariate Analysis of Predictive Outcome Variables in 98 Patients With Multiple Myeloma Who Developed Neutropenia-Related Aspergillosis
| Variable | Outcomea |
P | |
|---|---|---|---|
| Favorable | Unfavorable | ||
| Response based on s-GMI kineticsb | n = 72 | n = 25 | |
| At baseline | |||
| Body surface area, m2 | 1.89 (1.30–2.35) | 1.72 (1.40–2.55) | .03 |
| Body mass index | 26.15 (16.37–43.37) | 23.20 (16.20–42.48) | .04 |
| Active myeloma | 56 (77.8) | 24 (96.0) | .04 |
| Platelet count, ×103 platelets/mm3 | 95.5 (13–345) | 39 (7–258) | .005 |
| Serum bilirubin level, mg/dL | 0.6 (0.3–1.6) | 0.8 (0.3–2.2) | .01 |
| Iron overload | 32/68 (47.1) | 16 (72.7) | .04 |
| After diagnosis of aspergillosis | |||
| Normalization of s-GMIc | 34 (47.2) | 3 (12.0) | .002 |
| Neutrophil recoveryd | 71 (98.6) | 16 (64.0) | <.001 |
| Response based on the EORTC/MSG definitionse | n = 59 | n = 34 | |
| At baseline | |||
| Body mass index | 26.24 (16.37–43.37) | 23.25 (16.20–42.48) | .03 |
| Active myeloma | 44 (76.4) | 33 (97.1) | .006 |
| Platelet count, ×103 platelets/mm3 | 102 (13–345) | 44,5 (7–258) | .003 |
| Serum bilirubin level, mg/dL | 0.6 (0.3–1.0) | 0.7 (0.3–2.2) | .007 |
| Creatinine clearance rate, mL/min | 62 (2–171) | 51 (7–86) | .004 |
| After diagnosis of aspergillosis | |||
| ANC, neutrophils/mm3f | 50 (0–10,900) | 10 (0–5000) | .01 |
| Normalization of s-GMIc | 29 (49.2) | 7 (20.6) | .006 |
| Neutrophil recoveryd | 59 (100) | 24 (70.6) | <.001 |
| Response based on 6-week survival | n = 67 | n = 31 | |
| At baseline | |||
| Body mass index | 26.05 (16.37–43.37) | 23.20 (16.20–42.48) | .04 |
| Active myeloma | 50 (74.6) | 31 (100) | .002 |
| Previous ASCTs, No. | 1 (0–3) | 2 (0–4) | .02 |
| Receipt of other immunosuppressive agents | 7 (10.4) | 10 (32.3) | .008 |
| WBC count, cells/mm3 | 3840 (20–26,610) | 2510 (10–18,100) | .03 |
| Platelet count, ×103 platelets/mm3 | 102 (13–345) | 42 (7–258) | .001 |
| Serum bilirubin level, mg/dL | 0.6 (0.3–2.2) | 0.7 (0.3–1.6) | .02 |
| Creatinine clearance rate, mL/min | 62 (2–171) | 50 (7–85) | .001 |
| After diagnosis of aspergillosis | |||
| ANC, neutrophils/mm3f | 80 (0–10,900) | 10 (0–5000) | .01 |
| Normalization of s-GMIc | 30 (45.5) | 7 (22.6) | .03 |
| Neutrophil recoveryd | 67 (100) | 21 (67.7) | <.001 |
Data are No. or proportion (%) of patients or median (range). Outcomes were examined according to the kinetics of serum Aspergillus galactomannan, the EORTC/MSG response definitions, and 6-week survival. Variables were defined at baseline and after the diagnosis of aspergillosis.
Abbreviations: ANC, absolute neutrophil count; ASCT, autologous stem cell transplantation; EORTC/MSG, European Organization for Research and Treatment of Cancer/Mycosis Study Group; IA, invasive aspergillosis; s-GMI, serum Aspergillus galactomannan index; WBC, white blood cell.
a Favorable and unfavorable response outcomes are success and failure, respectively, for s-GMI kinetics and EORTC/MSG definitions; favorable and unfavorable outcomes are survived and died, respectively, for 6-week survival.
b Response by s-GMI kinetics was not assessed in 1 patient, who was lost to follow-up.
c Within 7 days after the first positive s-GMI.
d Defined as an ANC of ≥500 neutrophils/mm3 on 3 consecutive days.
e Response by EORTC/MSG was not assessed in 5 patients, who were not available for response assessment at 6 weeks.
f At diagnosis of IA.