tetano
Editor, Senior Moderator
J Med Virol. 2017 Aug 29. doi: 10.1002/jmv.24930. [Epub ahead of print]
[h=1]Influenza in Patients with Hematological Malignancies: Experience at Two Comprehensive Cancer Centers.[/h] Vilar-Compte D[SUP]1[/SUP], Shah DP[SUP]2[/SUP], Vanichanan J[SUP]2[/SUP], Cornejo-Juarez P[SUP]1[/SUP], Garcia-Horton A[SUP]1,[/SUP][SUP]3[/SUP], Volkow P[SUP]1[/SUP], Chemaly RF[SUP]2[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] The burden of influenza infections in patients with hematological malignancies (HMs) is not well defined.
[h=4]OBJECTIVE:[/h] To describe the associated outcomes at two comprehensive cancer centers (center 1 in the United States and center 2 in Mexico).
[h=4]PATIENTS/METHODS:[/h] Clinical and laboratory data on patients with HMs and influenza infection diagnosed from April 2009 to May 2014 at the two centers were reviewed retrospectively.
[h=4]RESULTS:[/h] In our cohort of 190 patients, the majority were male (63%) with a median age of 49 years (range, 1-88 years), and had active or refractory HMs (76%). Compared to center 1, patients in center 2 were significantly sicker (active cancer, decreased albumin levels, elevated creatinine levels, or hypoxia at influenza diagnosis) and experienced higher lower respiratory tract infection (LRI) rate (42% vs. 7%; P < 0.001). In multivariable logistic regression analysis (odds ratio, 95% confidence interval), leukemia, (3.09, 1.23-7.70), decreased albumin level (3.78, 1.55-9.20), hypoxia at diagnosis (14.98, 3.30-67.90), respiratory co-infection (5.87, 1.65-20.86), and corticosteroid use (2.71, 1.03-7.15) were significantly associated with LRI; and elevated creatinine level (3.33, 1.05-10.56), hypoxia at diagnosis (5.87, 1.12-30.77), and respiratory co-infection (6.30, 1.55-25.67) were significantly associated with 60 day mortality in both centers.
[h=4]CONCLUSIONS:[/h] HM patients with influenza are at high risk for serious complications such as LRI and death, especially if they are immunosuppressed. Patients with respiratory symptoms should seek prompt medical care during influenza season. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
[h=4]KEYWORDS:[/h] H1N1; Influenza; cancer; leukemia; lymphoma; myeloma; pneumonia
PMID: 28851056 DOI: 10.1002/jmv.24930
[h=1]Influenza in Patients with Hematological Malignancies: Experience at Two Comprehensive Cancer Centers.[/h] Vilar-Compte D[SUP]1[/SUP], Shah DP[SUP]2[/SUP], Vanichanan J[SUP]2[/SUP], Cornejo-Juarez P[SUP]1[/SUP], Garcia-Horton A[SUP]1,[/SUP][SUP]3[/SUP], Volkow P[SUP]1[/SUP], Chemaly RF[SUP]2[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] The burden of influenza infections in patients with hematological malignancies (HMs) is not well defined.
[h=4]OBJECTIVE:[/h] To describe the associated outcomes at two comprehensive cancer centers (center 1 in the United States and center 2 in Mexico).
[h=4]PATIENTS/METHODS:[/h] Clinical and laboratory data on patients with HMs and influenza infection diagnosed from April 2009 to May 2014 at the two centers were reviewed retrospectively.
[h=4]RESULTS:[/h] In our cohort of 190 patients, the majority were male (63%) with a median age of 49 years (range, 1-88 years), and had active or refractory HMs (76%). Compared to center 1, patients in center 2 were significantly sicker (active cancer, decreased albumin levels, elevated creatinine levels, or hypoxia at influenza diagnosis) and experienced higher lower respiratory tract infection (LRI) rate (42% vs. 7%; P < 0.001). In multivariable logistic regression analysis (odds ratio, 95% confidence interval), leukemia, (3.09, 1.23-7.70), decreased albumin level (3.78, 1.55-9.20), hypoxia at diagnosis (14.98, 3.30-67.90), respiratory co-infection (5.87, 1.65-20.86), and corticosteroid use (2.71, 1.03-7.15) were significantly associated with LRI; and elevated creatinine level (3.33, 1.05-10.56), hypoxia at diagnosis (5.87, 1.12-30.77), and respiratory co-infection (6.30, 1.55-25.67) were significantly associated with 60 day mortality in both centers.
[h=4]CONCLUSIONS:[/h] HM patients with influenza are at high risk for serious complications such as LRI and death, especially if they are immunosuppressed. Patients with respiratory symptoms should seek prompt medical care during influenza season. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
[h=4]KEYWORDS:[/h] H1N1; Influenza; cancer; leukemia; lymphoma; myeloma; pneumonia
PMID: 28851056 DOI: 10.1002/jmv.24930