Zheng Wenshuai, Wang Shenyu, Peng Bo, Gao Xiaoning
Department of Hematology, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, China.
Senior Department of Hematology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China.
Cancer Med. 2025 Apr;14(7):e70850. doi: 10.1002/cam4.70850.
Patients with hematologic malignancies are at high risk of dying from infectious diseases. However, little attention has been paid to infectious diseases mortality (IDM) in these patients. The aim of our study is to determine the incidence and trends of IDM in patients with hematologic malignancies, identify risk factors associated with IDM, and compare the risk of IDM in patients with the general United States population.
The data of patients with hematologic malignancies between 2000 and 2020 was retrieved from the Surveillance, Epidemiology, and End Results program. Standardized mortality ratios (SMRs) and IDM rates were calculated. A competing risk model was performed to identify potential risk factors of IDM.
Among 700,678 patients, 15,028 IDM were identified with an IDM rate of 401.31/100,000 person-years. Compared with the general population, the SMR of IDM was 3.34, and the elevated risk of IDM ran through the follow-up period. For all cancer subtypes, the IDM rates were highest in the first 2 months after diagnosis and gradually declined thereafter. For all patients, the early period of diagnosis, older age, male, non-Hispanic black, single or divorced/separated/widowed status, no chemotherapy, and no radiation were risk factors for IDM. For patients with Hodgkin lymphoma or non-Hodgkin lymphoma, advanced stage was also a risk factor for IDM.
Given the high risk of IDM in patients with hematologic malignancies, it is extremely important to identify patients at high risk of IDM and provide timely intervention to prevent early death from infections and improve prognosis.
血液系统恶性肿瘤患者死于感染性疾病的风险很高。然而，这些患者的感染性疾病死亡率（IDM）很少受到关注。我们研究的目的是确定血液系统恶性肿瘤患者IDM的发病率和趋势，识别与IDM相关的危险因素，并比较这些患者与美国普通人群的IDM风险。
从监测、流行病学和最终结果计划中检索2000年至2020年血液系统恶性肿瘤患者的数据。计算标准化死亡率（SMR）和IDM率。采用竞争风险模型识别IDM的潜在危险因素。
在700,678例患者中，确定了15,028例IDM，IDM率为401.31/100,000人年。与普通人群相比，IDM的SMR为3.34，且在随访期间IDM风险一直升高。对于所有癌症亚型，IDM率在诊断后的前2个月最高，此后逐渐下降。对于所有患者，诊断早期、年龄较大、男性、非西班牙裔黑人、单身或离婚/分居/丧偶状态、未接受化疗和未接受放疗是IDM的危险因素。对于霍奇金淋巴瘤或非霍奇金淋巴瘤患者，晚期也是IDM的危险因素。
鉴于血液系统恶性肿瘤患者IDM风险较高，识别IDM高风险患者并及时进行干预以预防感染导致的早期死亡并改善预后极为重要。
