Takaoka et al reported an Invasive Fungal Disease (IFD) score to determine the risk for an invasive fungal infection following salvage chemotherapy for malignant lymphoma. This can help to identify a patient who may benefit from prophylactic antifungal therapy. The authors are from the University of Tokyo.
Patient selection: malignant lymphoma (Hodgkin’s disease and non-Hodgkin’s) after salvage chemotherapy
Outcome: invasive fungal disease
Parameters:
(1) primary refractoriness
(2) previous treatment lines
(3) minimum absolute neutrophil count per microliter
|
Parameter
|
Findings
|
Points
|
|
primary refractory
|
no
|
0
|
|
|
yes
|
1
|
|
previous treatment lines
|
1
|
0
|
|
|
2
|
1
|
|
|
>= 3
|
2
|
|
minimum neutrophil count
|
<= 500
|
1
|
|
|
> 500
|
0
|
where:
• Salvage is used in the discussion to refer to treatment lines.
• Treatment “lines” is not clearly defined. It is assumed to mean courses of chemotherapy.
• Patients who developed fungal infections had progressive disease or partial response.
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 4
• The higher the score the greater the risk of an invasive fungal disease.
• A score <= 2 was low risk (0.2%) while a score >= 3 was higher risk (9%).
