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, Via F. Sforza 35, Milan 20122, Italy; and Division of Infectious Diseases, Dept of Medicine, University of Louisville, Louisville, Kentucky, USA
² Dept of Bioinformatics and Biostatistics, School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky, USA
³ Division of Infectious Diseases, Dept of Medicine, University of Louisville, Louisville, Kentucky, USA
⁴ Institute of Respiratory Disease, University of Milan, Ospedale Maggiore Fondazione IRCCS Policlinico, Mangiagalli e Regina Elena, Via F. Sforza 35, Milan 20122, Italy
⁵ Pneumology Service, La Fe University Hospital, Valencia, Spain
⁶ Division of Internal Medicine, Department of Medicine, Azienda Ospedaliera "S. Maria della Misericordia", Udine, Italy
⁷ Emergency Medicine Department, Ospedale Maggiore Fondazione IRCCS Policlinico, Mangiagalli e Regina Elena, Milan, Italy
⁸ Division of Infectious Diseases, Dept of Medicine, Hospital Bernardo Houssay, Buenos Aires, Argentina
⁹ Hospital Francisco J. Muñiz, Buenos Aires, Argentina

^* To whom correspondence should be addressed. E-mail: j.ramirez{at}louisville.edu.

	Abstract

Although the presence of neutropenia may predispose cancer patients to develop CAP, the role of neutropenia on their outcomes has not been investigated. The purpose of this study is to compare clinical outcomes of cancer CAP 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 3,106 CAP patients enrolled, 135 had cancer without neutropenia, while 75 had cancer with neutropenia. No significant difference was found between patients with and without neutropenia regarding time to clinical stability (5.4±2.7 mean days vs. 4.9±2.7 days, respectively, p=0.264), length of hospital stay (9.2±7.7 mean days vs. 9.9±9.6 days, p=0.638) and in-hospital mortality (18% vs. 15%, respectively, p=0.573). Using a multiple logistic regression model, neutropenia was not associated to mortality in cancer patients when adjusting for significant covariates (OR=1.30, p=0.615). Lack of neutropenia during the initial evaluation of a cancer CAP patient should not be considered an indicator of better clinical outcome.