A Multicenter Analysis of the Outcome of Cancer Patients with Neutropenia and COVID-19 Optionally Treated with Granulocyte-Colony Stimulating Factor (G-CSF): A Comparative Analysis

• Published in: Cancers Vol. 13; no. 16; p. 4205
• Main Authors: Sereno, María, Jimenez-Gordo, Ana María, Baena-Espinar, Javier, Aguado, Carlos, Mielgo, Xabier, Pertejo, Ana, Álvarez-Álvarez, Rosa, Sánchez, Ana, López, Jose Luis, Molina, Raquel, López-Alfonso, Ana, Hernández, Berta, Chiara, Luis Enrique, Martín, Ana Manuela, López-Martín, Ana, Dorta, Miriam, Collazo-Lorduy, Ana, Casado, Enrique, de Molina, Ana Ramirez, Colmenarejo, Gonzalo
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 20-08-2021; MDPI
• Subjects: Antibiotics; Cancer; Cancer therapies; Cardiovascular disease; Chemotherapy; Chronic obstructive pulmonary disease; Colony-stimulating factor; Comparative analysis; Coronaviruses; COVID-19; Cytokine storm; Cytokines; Diabetes; Epidemics; Fever; Granulocyte colony-stimulating factor; Immunotherapy; Infections; Leukocytes (granulocytic); Leukocytes (neutrophilic); Lymphocytes; Mortality; Myelosuppression; Neutropenia; Neutrophils; Pandemics; Patients; Pneumonia; Respiration; Severe acute respiratory syndrome coronavirus 2; Tumors; Spain
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers13164205

Background: Approximately 15% of patients infected by SARS-CoV-2 develop a distress syndrome secondary to a host hyperinflammatory response induced by a cytokine storm. Myelosuppression is associated with a higher risk of infections and mortality. There are data to support methods of management for neutropenia and COVID-19. We present a multicenter experience during the first COVID-19 outbreak in neutropenic cancer patients infected by SARS-CoV-2. Methods: Clinical retrospective data were collected from neutropenic cancer patients with COVID-19. Comorbidities, tumor type, stage, treatment, neutropenia severity, G-CSF, COVID-19 parameters, and mortality were analyzed. A bivariate analysis of the impact on mortality was carried out. Additionally, we performed a multivariable logistic regression to predict respiratory failure and death. Results: Among the 943 cancer patients screened, 83 patients (11.3%) simultaneously had neutropenia and an infection with COVID-19. The lungs (26%) and breasts (22%) were the primary locations affected, and most patients had advanced disease (67%). In the logistic model, as adjusted covariates, sex, age, treatment (palliative vs. curative), tumor type, and the lowest level of neutrophils were used. A significant effect was obtained for the number of days of G-CSF treatment (OR = 1.4, 95% CI [1,1,03,92], p-value = 0.01). Conclusions: Our findings suggest that a prolonged G-CSF treatment could be disadvantageous for these cancer patients with infections by COVID-19, with a higher probability of worse outcome.