Scholarlink

Background <p>Sepsis and septic shock are major causes of non-relapse mortality in cancer patients, with chemotherapy-induced neutropenia increasing infection risk. The prognostic impact of neutropenia remains unclear across cancer subtypes.</p> Patients and methods <p>We conducted a retrospective cohort study using the TriNetX Research Network, comprising deidentified data from over 141 million patients across 105 U.S. health care organizations. Adults with select solid cancers who received chemotherapy and developed severe sepsis with septic shock from 2013 to 2024 were included. Patients were stratified by neutropenia severity (&lt; 0.5 × 103/µL vs. 0.5–1.5 × 103/µL), and propensity score matching was applied to balance demographics, comorbidities, and treatment variables. Outcomes including short- and long-term mortality, organ failure, bacteremia, and immune-related adverse events were assessed using Kaplan–Meier survival analysis.</p> Results <p>Among 1083 eligible patients (184 severe, 899 mild–moderate neutropenia), severe neutropenia was associated with significantly worse survival at all timepoints, with median survival of 13&#xa0;days versus 106&#xa0;days and hazard ratios of 1.56–2.03 from 30&#xa0;days to 1&#xa0;year (all <i>p</i> &lt; 0.001). Secondary outcomes showed no difference in immune-related adverse events, a nonsignificant trend toward increased organ failure, and higher rates of bacteremia in the severe neutropenia cohort.</p> Conclusions <p>Greater severity of chemotherapy-associated neutropenia is linked to worse short-term survival and increased complications in cancer patients with septic shock. Stratifying by neutrophil count bands revealed that severe neutropenia (&lt; 0.5 × 10<sup>3</sup>/µL) independently predicts poorer outcomes, emphasizing its value for risk stratification and guiding clinical management.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

The impact of neutropenia severity in the setting of recent chemotherapy on mortality in sepsis

  • 期刊论文

  • 发表日期：

    2025年12月25日

查看全文
  • Shreyas Shirodkar,
  • Saad Javaid,
  • Jennifer Collins,
  • Khawaja Omar,
  • Amir Kamran

摘要

Background

Sepsis and septic shock are major causes of non-relapse mortality in cancer patients, with chemotherapy-induced neutropenia increasing infection risk. The prognostic impact of neutropenia remains unclear across cancer subtypes.

Patients and methods

We conducted a retrospective cohort study using the TriNetX Research Network, comprising deidentified data from over 141 million patients across 105 U.S. health care organizations. Adults with select solid cancers who received chemotherapy and developed severe sepsis with septic shock from 2013 to 2024 were included. Patients were stratified by neutropenia severity (< 0.5 × 103/µL vs. 0.5–1.5 × 103/µL), and propensity score matching was applied to balance demographics, comorbidities, and treatment variables. Outcomes including short- and long-term mortality, organ failure, bacteremia, and immune-related adverse events were assessed using Kaplan–Meier survival analysis.

Results

Among 1083 eligible patients (184 severe, 899 mild–moderate neutropenia), severe neutropenia was associated with significantly worse survival at all timepoints, with median survival of 13 days versus 106 days and hazard ratios of 1.56–2.03 from 30 days to 1 year (all p < 0.001). Secondary outcomes showed no difference in immune-related adverse events, a nonsignificant trend toward increased organ failure, and higher rates of bacteremia in the severe neutropenia cohort.

Conclusions

Greater severity of chemotherapy-associated neutropenia is linked to worse short-term survival and increased complications in cancer patients with septic shock. Stratifying by neutrophil count bands revealed that severe neutropenia (< 0.5 × 103/µL) independently predicts poorer outcomes, emphasizing its value for risk stratification and guiding clinical management.