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. 2018 Jan;90(1):50-60.
doi: 10.1002/jmv.24930. Epub 2017 Sep 14.

Influenza in patients with hematological malignancies: Experience at two comprehensive cancer centers

Diana Vilar-Compte  1 , Dimpy P Shah  2 , Jakapat Vanichanan  2 , Patricia Cornejo-Juarez  1 , Alejandro Garcia-Horton  1   3 , Patricia Volkow  1 , Roy F Chemaly  2
Affiliations

Influenza in patients with hematological malignancies: Experience at two comprehensive cancer centers

Diana Vilar-Compte et al. J Med Virol. 2018 Jan.

Abstract

The burden of influenza infections in patients with hematological malignancies (HMs) is not well defined. We describe the clinical presentation and associated outcomes of influenza at two comprehensive cancer centers (center 1 in the United States and center 2 in Mexico). 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. A total of 190 patients were included, 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. 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.

Keywords: H1N1; cancer; influenza; leukemia; lymphoma; myeloma; pneumonia.

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Conflict of interest statement

Financial Disclosures: The remaining authors declare no competing financial interests.

Figures

Figure 1
Figure 1
Symptom profile for HM patients with influenza in the 2009–2010 H1N1 pandemic and postpandemic periods in both cancer centers
Figure 2
Figure 2
All-cause mortality rates for the study patients following influenza diagnosis stratified according to cancer center and type of malignancy
Figure 3
Figure 3
All-cause mortality rates for the study patients following influenza diagnosis stratified by cancer center and LRI
See this image and copyright information in PMC

References

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