Previous treatment with anthracycline does not affect the course of sepsis in cancer patients: Retrospective cohort study
Background: Cancer patients who are exposed to sepsis and had previous chemotherapy may have increased severity. Among chemotherapeutic agents, anthracyclines have been associated with cardiac toxicity. Like other chemotherapeutic agents, they may cause endothelial toxicity. The aim of this study wa...
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Elsevier
2025-01-01
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| Series: | Journal of Intensive Medicine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667100X24000963 |
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| author | Camille Windsor Adrien Joseph Stephanie Pons Djamel Mokart Frederic Pène Achille Kouatchet Alexandre Demoule Fabrice Bruneel Martine Nyunga Edith Borcoman Matthieu Legrand Michael Darmon Lara Zafrani Elie Azoulay Virginie Lemiale |
| author_facet | Camille Windsor Adrien Joseph Stephanie Pons Djamel Mokart Frederic Pène Achille Kouatchet Alexandre Demoule Fabrice Bruneel Martine Nyunga Edith Borcoman Matthieu Legrand Michael Darmon Lara Zafrani Elie Azoulay Virginie Lemiale |
| author_sort | Camille Windsor |
| collection | DOAJ |
| description | Background: Cancer patients who are exposed to sepsis and had previous chemotherapy may have increased severity. Among chemotherapeutic agents, anthracyclines have been associated with cardiac toxicity. Like other chemotherapeutic agents, they may cause endothelial toxicity. The aim of this study was to evaluate the effect of anthracycline treatment on the outcome of cancer patients with sepsis. Methods: Data from cancer patients admitted to intensive care units (ICUs) for sepsis or septic shock were extracted from the Groupe de Recherche Respiratoire en Réanimation Onco-Hématologique database (1994–2015). Comparison between patients who received anthracycline and those who did not was performed using a propensity score, including confounding variables (age and underlying diseases). A competing risk adjusted for severity of illness (Sequential Organ Failure Assessment [SOFA] score) was used to analyze the duration of vasopressor requirement. Results: Among 2046 patients, 1070 (52.3%) patients who received anthracycline were compared with 976 (47.7%) who did not. The underlying disease was mostly acute hematological malignancy (49.2%). Sepsis, mostly pneumonia (47.7%), had developed 2 days (interquartile range [IQR]:1–4 days) prior to ICU admission. Most patients (n=1156/1980,58.4%) required vasopressors for 3 days (IQR: 2–6 days). Factors associated with the need for vasopressors were aplasia (hazard ratio [HR]=1.72, 95% confidence interval [CI]: 1.21 to 2.47, P=0.002) and day 1 respiratory SOFA score (HR=7.07, 95% CI: 2.75 to 22.1, P <0.001). Previous anthracycline treatment was not associated with an increased risk of vasopressor use. The duration of vasopressors was not different between patients who received anthracycline and those who did not (P=0.79). Anthracycline was not associated with ICU mortality. Conclusion: Previous anthracycline treatment did not alter the course of sepsis in a cohort of cancer patients admitted to intensive care with sepsis. |
| format | Article |
| id | doaj-art-d976837662774cb28864648e3664819b |
| institution | Kabale University |
| issn | 2667-100X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Intensive Medicine |
| spelling | doaj-art-d976837662774cb28864648e3664819b2025-01-05T04:28:47ZengElsevierJournal of Intensive Medicine2667-100X2025-01-01516469Previous treatment with anthracycline does not affect the course of sepsis in cancer patients: Retrospective cohort studyCamille Windsor0Adrien Joseph1Stephanie Pons2Djamel Mokart3Frederic Pène4Achille Kouatchet5Alexandre Demoule6Fabrice Bruneel7Martine Nyunga8Edith Borcoman9Matthieu Legrand10Michael Darmon11Lara Zafrani12Elie Azoulay13Virginie Lemiale14Medical Intensive Care Unit, APHP Saint-Louis University Hospital, Paris, France; Corresponding author: Camille Windsor, Médecine Intensive et Réanimation, APHP, Hôpital Henri Mondor, Paris Est Créteil University, 1 rue Gustave Eiffel, Créteil 94000, France.Medical Intensive Care Unit, APHP Saint-Louis University Hospital, Paris, FranceHuman Immunology and Immunopathology, Institut National de la Santé et de la Recherche Médicale (INSERM) U 976, University of Paris Cité, Paris, FranceCritical Care Department, Institut Paoli Calmettes, Marseille, FranceMedical Intensive Care Unit, APHP Cochin University Hospital, Paris, FranceMedical Intensive Care Unit, Centre Hospitalier Universitaire d'Angers, Angers, FranceMedical Intensive Care Unit, Hôpital Pitié-Salpêtrière, Paris, FranceMedical Intensive Care Unit, Centre Hospitalier de Versailles, Hopital Andre Mignot, Le Chesnay, FranceMedical Intensive Care Unit, Centre Hospitalier de Roubaix, Roubaix, FranceDepartment of Drug Development and Innovation (D3i), Institut Curie, Paris, FranceDepartment of Anesthesia and Perioperative Care, University of California, San Francisco, CA, USAMedical Intensive Care Unit, APHP Saint-Louis University Hospital, Paris, FranceMedical Intensive Care Unit, APHP Saint-Louis University Hospital, Paris, FranceMedical Intensive Care Unit, APHP Saint-Louis University Hospital, Paris, FranceMedical Intensive Care Unit, APHP Saint-Louis University Hospital, Paris, FranceBackground: Cancer patients who are exposed to sepsis and had previous chemotherapy may have increased severity. Among chemotherapeutic agents, anthracyclines have been associated with cardiac toxicity. Like other chemotherapeutic agents, they may cause endothelial toxicity. The aim of this study was to evaluate the effect of anthracycline treatment on the outcome of cancer patients with sepsis. Methods: Data from cancer patients admitted to intensive care units (ICUs) for sepsis or septic shock were extracted from the Groupe de Recherche Respiratoire en Réanimation Onco-Hématologique database (1994–2015). Comparison between patients who received anthracycline and those who did not was performed using a propensity score, including confounding variables (age and underlying diseases). A competing risk adjusted for severity of illness (Sequential Organ Failure Assessment [SOFA] score) was used to analyze the duration of vasopressor requirement. Results: Among 2046 patients, 1070 (52.3%) patients who received anthracycline were compared with 976 (47.7%) who did not. The underlying disease was mostly acute hematological malignancy (49.2%). Sepsis, mostly pneumonia (47.7%), had developed 2 days (interquartile range [IQR]:1–4 days) prior to ICU admission. Most patients (n=1156/1980,58.4%) required vasopressors for 3 days (IQR: 2–6 days). Factors associated with the need for vasopressors were aplasia (hazard ratio [HR]=1.72, 95% confidence interval [CI]: 1.21 to 2.47, P=0.002) and day 1 respiratory SOFA score (HR=7.07, 95% CI: 2.75 to 22.1, P <0.001). Previous anthracycline treatment was not associated with an increased risk of vasopressor use. The duration of vasopressors was not different between patients who received anthracycline and those who did not (P=0.79). Anthracycline was not associated with ICU mortality. Conclusion: Previous anthracycline treatment did not alter the course of sepsis in a cohort of cancer patients admitted to intensive care with sepsis.http://www.sciencedirect.com/science/article/pii/S2667100X24000963CancerSepsisICUAnthracyclineVasopressor |
| spellingShingle | Camille Windsor Adrien Joseph Stephanie Pons Djamel Mokart Frederic Pène Achille Kouatchet Alexandre Demoule Fabrice Bruneel Martine Nyunga Edith Borcoman Matthieu Legrand Michael Darmon Lara Zafrani Elie Azoulay Virginie Lemiale Previous treatment with anthracycline does not affect the course of sepsis in cancer patients: Retrospective cohort study Journal of Intensive Medicine Cancer Sepsis ICU Anthracycline Vasopressor |
| title | Previous treatment with anthracycline does not affect the course of sepsis in cancer patients: Retrospective cohort study |
| title_full | Previous treatment with anthracycline does not affect the course of sepsis in cancer patients: Retrospective cohort study |
| title_fullStr | Previous treatment with anthracycline does not affect the course of sepsis in cancer patients: Retrospective cohort study |
| title_full_unstemmed | Previous treatment with anthracycline does not affect the course of sepsis in cancer patients: Retrospective cohort study |
| title_short | Previous treatment with anthracycline does not affect the course of sepsis in cancer patients: Retrospective cohort study |
| title_sort | previous treatment with anthracycline does not affect the course of sepsis in cancer patients retrospective cohort study |
| topic | Cancer Sepsis ICU Anthracycline Vasopressor |
| url | http://www.sciencedirect.com/science/article/pii/S2667100X24000963 |
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