Table 1.
Clinical Characteristics of and Outcomes of Influenza in Patients with HMs in the Two Cancer Centers
| Number of patients (%) | |||
|---|---|---|---|
|
|
|||
| Characteristic | Center 1 (n=135) |
Center 2 (n=55) |
P |
| Median age, years (range) | 52 (1–88) | 45 (15–75) | 0.181 |
| Sex | 0.081 | ||
| Male | 80 (59) | 40 (73) | |
| Female | 55 (41) | 15 (27) | |
| Race | <0.001 | ||
| Non-Hispanic white | 75 (56) | 1 (2) | |
| Black | 23 (17) | 0 | |
| Hispanic | 29 (21) | 54 (98) | |
| Other | 8 (6) | 0 | |
| Type of malignancy | 0.387 | ||
| Acute leukemia | 52 (39) | 19 (35) | |
| Chronic leukemia | 25 (19) | 6 (11) | |
| Lymphoma | 38 (28) | 20 (36) | |
| Myeloma | 17 (13) | 10 (18) | |
| Other | 3 (2) | 0 | |
| Influenza season | 0.978 | ||
| H1N1 (April 2009–May 2010) | 42 (31) | 17 (31) | |
| Post-H1N1 (November 2010–February 2014) | 93 (69) | 38 (69) | |
| Cancer status | 0.008 | ||
| Remission | 39 (29) | 6 (11) | |
| Active/refractory | 96 (71) | 49 (89) | |
| Systemic chemotherapy use | 101 (75) | 44 (80) | 0.494 |
| Corticosteroid use | 26 (19) | 25 (45) | <0.001 |
| Median BMI, kg/m2 (range) | 27 (13–63) | 25 (17–45) | 0.071 |
| WHO classification of BMI | 0.145 | ||
| Underweight (<18.5 kg/m2) | 15 (11) | 4 (7) | |
| Normal (18.50–24.99 kg/m2) | 35 (26) | 21 (38) | |
| Overweight (25.00–29.99 kg/m2) | 36 (27) | 18 (33) | |
| Obesea (≥30 kg/m2) | 48 (36) | 12 (22) | |
| Infection site at diagnosis | 0.089 | ||
| Upper respiratory tract | 98 (73) | 33 (60) | |
| Lower respiratory tract | 37 (27) | 22 (40) | |
| Laboratory abnormalities at presentation | |||
| Leukocytosis (WBC >11,000 cells/mm3) | 11 (8) | 8 (15) | 0.134 |
| Neutropenia (ANC <500 cells/mL) | 26 (19) | 12 (22) | 0.689 |
| Lymphocytopenia (ALC <200 cells/mL) | 26 (19) | 12 (22) | 0.689 |
| Elevated creatinine level (>1.3 mg/dL) | 19 (14) | 15 (27) | 0.031 |
| Decreased albumin level (<3.5 g/dL) | 41 (30) | 34 (62) | <0.001 |
| Hypoxia at influenza diagnosis | 9 (7) | 40 (73) | <0.001 |
| Outcome | |||
| Admission to hospital | 76 (56) | 47 (85) | <0.001 |
| Median length of hospital stay, days (range) | 7 (2–75) | 11 (1–49) | 0.039 |
| ICU admission | |||
| At onset of infection | 4 (3) | 1 (2) | 1.000 |
| Later | 11 (8) | 13 (24) | 0.001 |
| Mechanical ventilation | 8 (6) | 19 (35) | <0.001 |
| Oxygen supplementation | 33 (24) | 39 (71) | 0.510 |
| Antiviral therapy | 112 (83) | 49 (89) | 0.287 |
| Within 24 hours of symptom onset | 13 (10) | 8 (15) | 0.327 |
| Within 48 hours of symptom onset | 35 (26) | 19 (35) | 0.232 |
| Duration of antiviral therapy | 6 (2–18) | 9 (1–28) | 0.099 |
| Progression from URI to LRI | 7/98 (7) | 14/33 (42) | <0.001 |
| Co-infection | 26 (19) | 10 (18) | 0.864 |
| Respiratory co-pathogen | 23 (17) | 5 (9) | 0.183 |
| All-cause mortality | 10 (7) | 20 (36) | <0.001 |
| Median time from influenza diagnosis to death, days (range) | 16 (7–39) | 7 (1–47) | 0.095 |
Abbreviations: WHO, World Health Organization; WBC, white blood count; ANC, absolute neutrophil count; ALC, absolute lymphocyte count; ICU, intensive care unit.
a
Obesity was defined as a BMI of at least 30 kg/m2 in adults 18 years of age or older or a BMI percentile of 95–100% in children 1 to 18 years old.