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

Sepsis accounts for a significant proportion of global deaths and has limited treatment options. Cancer patients are at a higher risk of sepsis and experience worse outcomes, highlighting the complex interplay between sepsis and cancer on immune cell function and clinical prognosis.

Between July and December 2023, we prospectively enrolled 30 sepsis patients and 10 healthy controls, categorizing the patients into sepsis with non-cancer and sepsis with cancer based on established clinical diagnostics. Multi-color flow cytometry was used to monitor changes in the expression of surface molecules of monocyte and neutrophil subsets, phagocytic activity and cytokine-producing capacity.

Compared with sepsis with non-cancer, the sepsis with cancer group demonstrated elevated 28-day mortality rates, increased CD177⁺ activated band neutrophil and HLA-DR^lowCCR2^low classical monocyte, and attenuated phagocytic activity of immature neutrophil and monocyte. Further, HLA-DR^lowCCR2^low classical monocytes and CD177⁺ myelocytes may serve as immunological predictors of adverse outcomes in sepsis. The HLA-DR^lowCCR2^low classical monocyte and CD177⁺ myelocytes exhibit significant correlations with internal environment and coagulation markers.

In septic patients, particularly those patients with cancer, attenuated phagocytic activity of immature neutrophil (myelocytes, metamyelocytes, band neutrophils) and monocyte, and HLA-DR^lowCCR2^low classical monocyte and CD177⁺ myelocytes may serve as immunological predictors of poor prognosis.