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The role of neutropenia on outcomes of cancer patients with community-acquired pneumonia

¹ Institute of Respiratory Disease, University of Milan, Ospedale Maggiore Fondazione IRCCS Policlinico, Mangiagalli e Regina Elena, and ⁶ Emergency Medicine Dept, Ospedale Maggiore Fondazione IRCCS Policlinico, Mangiagalli e Regina Elena, Milan, and ⁵ Division of Internal Medicine, Dept of Medicine, Azienda Ospedaliera "S. Maria della Misericordia", Udine, Italy., ² Division of Infectious Diseases, Dept of Medicine, University of Louisville, and ³ Dept of Bioinformatics and Biostatistics, School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky, USA. ⁴ Pneumology Service, La Fe University Hospital, Valencia, Spain. ⁷ Division of Infectious Diseases, Dept of Medicine, Hospital Bernardo Houssay, and ⁸ Hospital Francisco J. Muñiz, Buenos Aires, Argentina.

CORRESPONDENCE: J. A. Ramirez, Division of Infectious Diseases, Dept of Medicine, University of Louisville, Louisville, KY, USA. Fax: 1 5028521147. E-mail: j.ramirez{at}louisville.edu

Keywords: Cancer, community-acquired pneumonia, neutropenia, outcomes

Received: December 13, 2007
Accepted September 16, 2008

Although the presence of neutropenia may predispose cancer patients to develop community-acquired pneumonia, the role of neutropenia on their outcomes has not been investigated. The purpose of the present study was to compare clinical outcomes of cancer community-acquired pneumonia patients with and without neutropenia.

Patients with cancer, identified in the Community-Acquired Pneumonia Organization database, were divided into two groups according to the type of cancer and the presence of neutropenia: patients with solid cancer without neutropenia versus those with functional or absolute neutropenia. Among the 3,106 community-acquired pneumonia patients enrolled, 135 had cancer without neutropenia and 75 had cancer with neutropenia.

No significant difference was found between patients with and without neutropenia regarding mean time to clinical stability (5.4±2.7 versus 4.9±2.7 days, respectively), mean length of hospital stay (9.2±7.7 versus 9.9±9.6 days) and in-hospital mortality (18 versus 15%, respectively). Using a multiple logistic regression model, neutropenia was not associated with mortality in cancer patients when adjusting for significant covariates (odds ratio 1.30).

Lack of neutropenia, during the initial evaluation of a cancer community-acquired pneumonia patient, should not be considered an indicator of better clinical outcome.