Characterization of leukocytosis in patients with solid tumors with and without an infectious process

Abstract

Introduction: Leukocytosis in cancer patients with solid tumors is the second reason for consultation and antibiotic therapy is generally indicated. However, if leukocytosis is a common sign of infections, particularly bacterial, there are other stressors capable of causing an acute leukocytosis that include surgeries, intense exercise, trauma, emotional stress, neoplasms, among others, which is why antibiotic therapy should not be generalized.

Objective: To characterize leukocytosis in patients with solid tumors with and without an infectious process who attended from January 2021 to August 2023 for consultation with infectology of the National Cancer Institute.

Materials and methods: descriptive, observational, cross-sectional design, with secondary data. Data were processed from 144 cases of hospitalized patients diagnosed with solid oncological tumors or awaiting confirmatory results, who requested consultation with the infectious disease specialist due to the presence of leukocytosis in the blood count in the absence of infectious symptoms or persistence of leukocytosis despite a successful antibiotic treatment. Descriptive statistics were used for data processing and approval was obtained from the INCAN Ethics Committee.

Result: Of the 144 patients, 44 (30.5%) presented some infectious process evident by clinical or auxiliary diagnostic methods. In 100patients (69.5%) the presence of any infectious process could not be evidenced based on clinical parameters and auxiliary diagnostic methods. The phenomenon of leukocytosis and neutrophilia was observed in all cases in both groups of patients, even after antibiotic treatment in those who presented it. Thrombocytosis was observed in 23/100 patients without an infectious diagnosis (23%), versus 23/44 (52.2%) patients with an active infectious process.

Conclusion: Leukocyte reactivity is a common hematological phenomenon in neoplastic processes and persists even after successful antibiotic treatment. The infectious processes were evident, specific, diverse and without significant predominance of any particular entity, so empirical antibiotic therapy should be postponed.