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

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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 low CCR2 low classical monocyte, and attenuated phagocytic activity of immature neutrophil and monocyte. Further, HLA-DR low CCR2 low classical monocytes and CD177 + myelocytes may serve as immunological predictors of adverse outcomes in sepsis. The HLA-DR low CCR2 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 low CCR2 low classical monocyte and CD177 + myelocytes may serve as immunological predictors of poor prognosis.