The Prognostic Utility of Lymphocyte-Based Measures and Ratios in Chemotherapy-Induced Febrile Neutropenia Patients following Granulocyte Colony-Stimulating Factor Therapy

Background and Objectives: Chemotherapy-induced febrile neutropenia is the most widespread oncologic emergency with high morbidity and mortality rates. Herein we present a retrospective risk factor identification study to evaluate the prognostic role of lymphocyte-based measures and ratios in a cohort of chemotherapy-induced febrile neutropenia patients following granulocyte colony-stimulating factor (G-CSF) therapy. Materials and Methods: The electronic medical records at our center were utilized to identify patients with a first attack of chemotherapy-induced febrile neutropenia and were treated accordingly with G-CSF between January 2010 to December 2020. Patients’ demographics and disease characteristics along with laboratory tests data were extracted. Prognosis-related indicators were the absolute neutrophil count (ANC) at admission and the following 6 days besides the length of stay and mortality rate. Results: A total of 80 patients were enrolled, which were divided according to the absolute lymphocyte count at admission into two groups, the first includes lymphopenia patients (n = 55) and the other is the non-lymphopenia group (n = 25) with a cutoff point of 700 lymphocytes/μL. Demographics and baseline characteristics were generally insignificant among the two groups but the white blood cell count was higher in the non-lymphopenia group. ANC, neutrophils percentage and ANC difference in reference to admission among the two study groups were totally insignificant. The same insignificant pattern was observed in the length of stay and the mortality rate. Univariate analysis utilizing the ANC difference compared to the admission day as the dependent variable, revealed no predictability role in the first three days of follow up for any of the variables included. However, during the fourth day of follow up, both WBC (OR = 0.261; 95% CI: 0.075, 0.908; p = 0.035) and lymphocyte percentage (OR = 1.074; 95% CI: 1.012, 1.141; p = 0.019) were marginally significant, in which increasing WBC was associated with a reduction in the likelihood of ANC count increase, compared to the lymphocyte percentage which exhibited an increase in the likelihood. In comparison, sequential ANC difference models demonstrated lymphocyte percentage (OR = 0.961; 95% CI: 0.932, 0.991; p = 0.011) and monocyte-to-lymphocyte ratio (OR = 7.436; 95% CI: 1.024, 54.020; p = 0.047) reduction and increment in the enhancement of ANC levels, respectively. The fifth day had WBC (OR = 0.790; 95% CI: 0.675, 0.925; p = 0.003) to be significantly decreasing the likelihood of ANC increment. Conclusions: we were unable to determine any concrete prognostic role of lymphocyte-related measures and ratios. It is plausible that several limitations could have influenced the results obtained, but as far as our analysis is concerned ALC role as a predictive factor for ANC changes remains questionable

Eco-Friendly Degradation of Natural Rubber Powder Waste Using Some Microorganisms with Focus on Antioxidant and Antibacterial Activities of Biodegraded Rubber

Natural rubber (NR) powder wastes contribute to the pollution of the environment and pose a risk to human health. Therefore, Escherichia coli AY1 and Aspergillus oryzae were used to degrade NR in the present investigation. The biodegradation was further confirmed using E. coli AY1 and A. oryzae’s ability to create biofilm, which grew on the surface of the NR. Additionally, the biodegraded NR was examined by scanning electron microscopy (SEM), attenuated total reflection–Fourier transform infrared (ATR–FTIR) spectroscopy, and gas chromatography–mass spectrometry (GC–MS). The highest weight loss (69%) of NR was detected (p E. coli AY1 + A. oryzae). In the SEM, the surface of the control treatment appeared uniform and normal, whereas the surface of the microbial treatment displayed an irregular shape, with apparent particle deformation and surface erosion. After biodegradation by E. coli AY1 and A. oryzae, the particle size range of the untreated NR dropped from (5.367–9.623 µm) to (2.55–6.549 µm). After treating NR with E. coli AY1 and A. oryzae, new bands appeared in the ATR–FTIR technique; others shifted down in the range of 3910–450 cm−1, suggesting the existence of active groups belonging to alcohol, secondary amine, aromatic amine, conjugated anhydride, aldehyde, alkene, and halo compounds. On the other hand, the GC–MS profile reports a significant decline (p p E. coli AY1 and A. oryzae, which rose 9-fold (p < 0.05) compared to untreated NR. Through the use of this research, we will be able to transform NR waste into a valuable product that possesses both antioxidant and antibacterial properties