Incidence and Mortality. Effect of Chemotherapy on Pneumonia Mortality. 1999;281(24):230515. Clin Med (Lond). Therefore, funder had no role in the study. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Our study found that pneumonia and influenza are the most common infectious diseases causing death among cancer patients, which is a common cause of hospital admission in 10% of cancer patients, especially in those with hematological malignancies. 2019;98(5):105169. J Antimicrob Chemother. Avoidable cancer deaths globally. We also examined the risk factors associated with a higher risk of death due to infectious diseases. Moreover, many studies were performed prior to availability of . 2010;14(1):816. 2007;59(4):46472. The overall incidence from 1973 to 2014 showed an insignificant decrease (annual percentage change=0.3, 95% confidence interval [CI]=2.21.7, P=0.8). Schiller JT, Lowy DR. J Acquir Immune Defic Syndr. However, the relationship between aspiration pneumonia occurring during CRT or BRT for HNC and treatment outcomes in HNC patients is not well characterized. Clarke RT, et al. Goldszmid RS, Dzutsev A, Trinchieri G. Host immune response to infection and cancer: unexpected commonalities. Parasitic and other infectious diseases, including HIV (standardized incidence ratio [SIR]=1.77, 95% CI=1.691.84), had the highest incidence, followed by septicemia (SIR=0.84, 95% CI=0.810.88), tuberculosis (SIR=0.72, 95% CI=0.510.99), and pneumonia (SIR=0.63, 95% CI=0.610.64). Some have suggested that monotherapy may be considered in patients with low-risk CAP [11, 12]. Single versus combination antibiotic therapy in adults hospitalised with community-acquired pneumonia. However, there is a need for vaccinations against viral and bacterial causes of common infections to reduce the burden of antimicrobial resistance [33]. 2010;21(Suppl 5):v2526. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Ann Hematol. Baluch A, Shewayish S. Neutropenic fever. Moore RD. Pardoll D. Cancer and the immune system: basic concepts and targets for intervention. Hematologic malignancies such as acute leukemia, aplastic anemia, or myelodysplastic syndrome that accompany prolonged neutropenia due to intensive chemotherapy or the nature of the disease, were excluded from the analysis because prolonged neutropenia, a strong prognostic factor of febrile neutropenia, may obscure the effect of antibiotics [1, 13, 14]. Effect of Chemotherapy on Pneumonia Mortality - PubMed It achieved a brier score of 0.2. Effect of Chemotherapy on Pneumonia Mortality Br Med J. van der Eerden MM, Vlaspolder F, de Graaff CS, Groot T, Jansen HM, Boersma WG. Combination antibiotic regimens were not associated with a survival benefit over -lactam monotherapy in the treatment of community-onset neutropenic pneumonia. Cancer as a cause of death among people with AIDS in the United States. 1943 Jun 12; 1 (4301):717-719. Lopez-Pousa A, Rifa J, Casas de Tejerina A, Gonzalez-Larriba JL, Iglesias C, Gasquet JA, et al. Additionally, patients with vascular tumors that include various tumors, especially Kaposi sarcoma, had the highest incidence of parasitic and HIV infection as a cause of mortality. Thorax. In the -lactam group, 30-day (15.3% versus 4.3%, P=0.015) and 90-day all-cause mortality (20.8% versus 7.5%, P=0.013) were significantly higher. HIV infection triggers the development of malignancies and is marked by severe immunosuppression, which may increase the risk of death due to infectious diseases [7, 8]. Infectious Agents and Cancer 1976;55(3):25968. Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, et al. However, several studies have shown that -lactam monotherapy is non-inferior to combination therapy [8,9,10]. The study protocol was approved by the Institutional Review Board of Samsung Medical Center. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Gonzalez C, et al. This study aimed to answer the question of whether combination therapy is necessary in patients with neutropenic pneumonia. Dwyer R, Ortqvist A, Aufwerber E, Henriques Normark B, Marrie TJ, Mufson MA, et al. Fever was defined as body temperature38.0C. Clin Chest Med. Cancer. 2018;36(30):304354. This may be because pneumonia typically affects older patients compared to younger patients, as older patients are usually hospitalized for pneumonia [34]. Data regarding age, sex, grade, laterality, race, behavior (benign, borderline, in situ, and malignant), marital status, survival time, tumor site, and time of diagnosis were available from the SEER database. Klastersky J, Paesmans M, Rubenstein EB, Boyer M, Elting L, Feld R, et al. Infect Agents Cancer 16, 72 (2021). HIV Outpatient Study Investigators. Ann Plast Surg. The increasing risk of infection can be attributed to cancer itself, chemotherapy, unhealthy diet, and other diseases or conditions that are not associated with cancer, such as chronic diseases and aging [10,11,12]. 1-4 Significantly higher mortality rates are also observed in non . Chang J. To verify the effect of combination therapy on all-cause mortality due to neutropenic pneumonia, we also performed a subgroup analysis controlling for -lactam antibiotics, specifically cefepime which made up the highest proportion among the various -lactams (63.0%). Curr Opin Pulm Med. Therefore, there is a need to evaluate patients at risk of severe infection. 2014;9(4):23945. PubMed 2013;346:f1235. The patients mean age was 66.33years; majority of them were male (62%). Additionally, older patients usually have chronic medical conditions that, along with frailty, put them at a higher risk of contracting the infection and developing severe complications, thus increasing the risk of mortality [56]. This is in line with our results that indicated a decreasing trend in death due to infectious diseases between 1993 and 1998. Old black men with intrahepatic tumor or acute leukemia of different grades, except the well-differentiated grade, had the highest risk of dying from infectious diseases. Download .nbib Clin J Oncol Nurs. Jansen KU, Knirsch C, Anderson AS. Ann Oncol. Management of breast cancer patients with chemotherapy-induced neutropenia or febrile neutropenia. I would like to thank Sara from Tanta University for providing assistance in the statistical analysis. Schembri S, Williamson PA, Short PM, Singanayagam A, Akram A, Taylor J, et al. Using antimicrobial adjuvant therapy in cancer treatment: a review. African American cancer patients were more likely to die from infection than other races. Pneumonia in the neutropenic cancer patient. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. & Msherghi, A. 2000;46(6):97380. Cancer. 2014;9(1):3440. Early recognition of risk factors and timely intervention may help mitigate the negative consequences on patients quality of life and prognosis, improving the prognosis and preventing early death from infection, which is preventable in most cases. No patient received oral prophylactic antibiotics before the onset of neutropenic fever. 2017;38(2):26377. Spina M, et al. To compare the two groups, the Pearson 2 test and Fishers exact test were used for categorical variables, and Students t-test and the Mann-Whitney U test for continuous variables. All P-values were two-tailed, and those <0.05 were considered to be statistically significant. Basal cell neoplasms had the highest risk of mortality from infections. A significant difference was found in the survival between men and women (P<0.0001), different organisms, race, and marital status (P<0.0001). JAMA Oncol. New immunosuppressive therapies produce a variety of immune vulnerabilities that form the basis of opportunistic infections. In the present study, the 28-day pneumonia-related mortality rate of patients categorized by CURB-65 scores <2 or low risk, . Article Intensive Care Med. Among non-hospitalized cancer patients being treated with chemotherapy, approximately 3% of deaths are caused by PE. Infection is a common cause of breast cancer-related hospitalization, a major cause of morbidity, and an independent predictor of mortality [38]. PubMedGoogle Scholar. Cancer. Hariri S, McKenna MT. Effect of Chemotherapy on Pneumonia Mortality - PMC A retrospective cohort study was conducted to compare the effects of combination antibiotic regimens to those of -lactam monotherapy in cancer patients with community-onset neutropenic pneumonia. -lactam monotherapy was not associated with 30- and 90-day mortality in the multivariate analysis. Survival decision tree identifying the four groups with their respective predicted survival. 2018;378(11):102941. All data associated with this study is available at www.seer.cancer.gov. Serologic tests for Mycoplasma pneumoniae were conducted in 20 patients (12.1%), two of which yielded positive results. Daxboeck F, Krause R, Wenisch C. Laboratory diagnosis of mycoplasma pneumoniae infection. All statistical analyses were performed using SPSS Statistics version 20.0 for Windows (IBM Corp., Armonk, NY, USA). Cancer Treat Res. Trend analysis of cancer patients who died because of infectious diseases. Epidemiology of infections in cancer patients. The nomogram was subjected to 1000 bootstrap resamples for internal validation to correct the C-index and explain the variance. Causative pathogens of neutropenic pneumonia were identified in 27.9% of the patients, of which Streptococcus pneumoniae was the most common followed by Pseudomonas aeruginosa, Staphylococcus aureus, and Klebsiella pneumoniae (23.9, 19.6, 15.2, and 13.0%, respectively; Additional file 1: Table S1). Patients who were re-admitted 7days after discharge were excluded because they were assumed to have hospital-acquired pneumonia. Small Cell Lung Cancer Treatment (PDQ) - NCI Nosocomial aspergillosis has been recognized increasingly as a cause of severe illness and mortality in highly immunocompromised patients (e.g., patients undergoing chemotherapy and/or organ transplantation, including bone-marrow transplantation for hematologic and other malignant neoplasms) (468-472). Second, we did not separately evaluate HIV and instead assessed this condition along with parasitic infection, which may not help distinguish both in terms of survival and related trends in which we draw observations based on the currently available data. Writing original draft: HS, JHK. Systemic chemotherapy for lung cancer may extend the prognosis of patients with concomitant lung cancer and IP 6 , 7 ; however, the specific protective and risk factors in these patients are not yet completely understood. Results of multivariate analysis showed that absence of involvement of palliative care team and ECOG-PS of 3 or better independently predisposed patients to receive chemotherapy within . 2014;3(4):96270. A multivariate analysis for 90-day all-cause mortality was performed (Additionalfile2: Table S2). Due to the extended study period of 20years, there were considerable differences in the types of -lactams between the two groups. Appropriate risk stratification for primary and secondary VTE prevention as well as for risk of early death in acute setting is needed for an adequate treatment. Our sample included 151,440 patients who died of infectious diseases (mean age, 66.33years; 62% male). Google Scholar. Cancer-associated venous thromboembolism (VTE) is a leading cause of morbidity and mortality in patients with cancer. The significant variables obtained from the Cox regression analysis were used to construct a nomogram. 2023 BioMed Central Ltd unless otherwise stated. 3). Author T Anderson. The outcomes and complications of patients with neutropenic pneumonia are summarized in Table3. Risk factors for treatment-related death associated with chemotherapy Global, regional, and national incidence, prevalence, and mortality of HIV, 19802017, and forecasts to 2030, for 195 countries and territories: a systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017.