Sepsis with Cancer is Marked by a Dysregulated Myeloid Cell Compartment: A Pilot Study

Area of Science:

• Immunology
• Oncology
• Critical Care Medicine

Background:

• Sepsis is a leading cause of death with limited treatments.
• Cancer patients have increased sepsis risk and poorer outcomes.
• The interaction between cancer and sepsis impacts immune function and prognosis.

Purpose of the Study:

• To investigate immune cell alterations in sepsis patients with and without cancer.
• To identify potential immunological predictors of sepsis outcomes.

Main Methods:

• Prospective enrollment of 30 sepsis patients and 10 healthy controls (July-December 2023).
• Categorization into sepsis with non-cancer and sepsis with cancer groups.
• Multi-color flow cytometry to analyze monocyte and neutrophil subsets, phagocytic activity, and cytokine production.

Main Results:

• Sepsis with cancer group showed higher 28-day mortality.
• Elevated CD177+ activated band neutrophils and HLA-DRlowCCR2low classical monocytes observed in sepsis with cancer.
• Attenuated phagocytic activity in immature neutrophils and monocytes in sepsis with cancer patients.
• HLA-DRlowCCR2low classical monocytes and CD177+ myelocytes correlated with internal environment and coagulation markers.

Conclusions:

• Attenuated phagocytic activity and specific monocyte/neutrophil subsets (HLA-DRlowCCR2low classical monocytes, CD177+ myelocytes) are immunological predictors of poor prognosis in sepsis.
• These findings are particularly relevant for sepsis patients with cancer.