Abstract 1569P
Background
SARS-CoV-2 infection can induce a host hyperinflammatory response induced by a cytokine storm, that is the main cause of mortality. Myelosuppression is associated with higher risk of infections and mortality. Few reports have addressed about the management of patients with neutropenia and COVID-19. Herein, we present a retrospective study during COVID-19 outbreak in neutropenic cancer patients with COVID-19 comparing the outcome and survival between G-CSF treated vs G-CSF non-treated group.
Methods
Retrospective data were collected from clinical reports. Inclusion criteria were cancer with neutropenia (<1500 cells/mm3) and concomitant COVID-19 infection. Comorbidities, tumor, stage, treatment, neutropenia severity, G-CSF, COVID-19 parameters and mortality were analyzed. Exploratory analysis of both cohorts (G-CSF treated and G-CSF non treated) and a multivariable logistic regression was done to predict respiratory failure and death.
Results
Among 943 patients with cancer and COVID-19 from14 hospitals in Spain, 8% had neutropenia. Two cohorts according to G-CSF treatment were identified: 40 patients received G-CSF vs 43 G-CSF non-treated. Lung (26%) was the main location and most had advanced disease (67%). No differences according to baseline characteristics were found, except for the cancer treatment and the center´s protocols for neutropenia management (p=0,001). 63% of patients died because respiratory failure. Neumonia was presented in 76% of patients. Patients treated with G-CSF had a higher rate of respiratory failure vs non-treated (p=0.001) and required oxygen support (p=0.002). In G-CSF treated cohort, we found that the days with G-CSF showed a significant trend toward worse outcome and higher mortality. A logistic regression model was developed to predict respiratory failure as a function of the days of G-CSF treatment. After adjusting several relevant covariates, a significant effect was obtained for the days of G-CSF treatment (OR = 1.4, 95% CI [1.03, 1.92], p-value = 0.01).
Conclusions
Our findings suggest that G-CSF treatment could be disadvantageous in cancer patients with COVID-19, with a probable worse outcome.
Clinical trial identification
NA
Editorial acknowledgement
NA
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.