Risk Factors for Mortality Associated With Influenza Infection in Patients With Hematologic Malignancies: A...

Cancer patients, especially those with hematologic malignancies (HMs), are considered among the most vulnerable groups at risk for severe outcomes from influenza infection. This study aimed to investigate influenza infection in patients with HMs and identify the risk factors associated with mortality.

This cross-sectional descriptive observational study included 90 patients with confirmed influenza infection and HMs. The data collected included demographic information, cancer type and status, influenza type, symptoms, laboratory and radiologic findings, length of hospital stay, ICU admissions, and mortality rate. The primary outcome was analysis endpoints included mortality risk factors based on ICU admission, death and type of malignancies.

The mean age of patients was 34.3 ± 26.7 years (median 34, range 2-91). Most had acute lymphoblastic leukemia (ALL, 45.6%), followed by acute myeloid leukemia (AML, 22.2%), lymphomas (14.4%), multiple myeloma (MM, 6.7%), chronic myelogenous leukemia (CML, 2.2%), and other malignancies (8.9%). Nearly half (49.3%) were in the maintenance phase of treatment, and 80% were infected with influenza A. Pleural effusion (22.2%) and ground-glass opacities (17.8%) were the most common radiologic findings. ICU admission was significantly linked to older age (p = 0.002), comorbidity (p = 0.003), lower respiratory tract infection (LRTI) (p = 0.02), muscle ache (p = 0.03), and malignancies including MM, CML, and AML (p = 0.02). Higher mortality was observed in patients with MM or AML (p = 0.01), comorbidities (p = 0.02), and LRTIs (p = 0.04). Age-adjusted analysis confirmed MM, LRTI, and comorbidity as potential strong predictors of mortality.

ICU admission was significantly associated with older age, the presence of at least one comorbidity, LRTI, and body muscle aches. MM, CML, and AML were notably more associated with ICU admission. Patients diagnosed with MM and AML, those with at least one comorbidity, and those with LRTIs had a higher risk of mortality. The age-adjusted analysis identified MM, LRTIs, and comorbidities as potential strong predictors of mortality in this cohort, requiring validation in larger studies.