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

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.