Immunosuppression risk groups

Immunosuppression risk groups of the Commission for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute

Risk group 1 (moderate immunosuppression/deficiency)

• Granulocytopenia <0.5×109/l (<500/µl) up to 10 days (analog leukopenia <1×109/l; <1000/µl) -
• Deficiency of CD4-positive THelfer cells <250/µl (cave: age-appropriate normal values in children); autologous stem cell transplantation up to three months after intensive therapy
• Patients who have more than 1 characteristic of the immunosuppression/deficiency listed under risk group 1 are placed in risk group 2.

Risk group 2 (severe immunosuppression/deficiency)

• Granulocytopenia <0.5×109/l (<500/µl) for more than 10 days (analogous leukopenia <1×109/l; <1000/µl)
• Severe aplastic anemia or macrophage activation syndrome during intensive immunosuppressive therapy
• Allogeneic bone marrow or/and stem cell transplantation up to 6 months after completion of the intensive therapy phase (important: extent of GVHD and persistent iatrogenic immunosuppression) -
• Acute inpatient treatment phase for autologous stem cell transplantation or after transplantation of solid organs (until discharge)

Risk group 3 (very severe immunosuppression/deficiency)

• Allogenic KMT/PBSCT in intensive therapy phase (until engraftment = regeneration of granulopoiesis)
• Severe GVHD grade III or IV under intensive immunosuppression The decision on the assignment to group 3 in patients after allogeneic stem cell transplantation is ultimately made by the treating oncologists in summary of all findings.