Admissions For Neutropenic Fever In Myelodysplastic Syndromes (Mds).

e18548 Background: MDS are associated with a risk of severe infections due to disease course, patient (pt) age, co-morbidities and treatment. While infection rates have been reported for MDS patients enrolled in clinical trials, the real-world incidence of infections that require hospitalization, and how disease related factors (e.g. genetic mutations) affect the likelihood of infection remain unclear. Methods: Clinical data for MDS pts (per 2016 WHO criteria) diagnosed between 1/2010-12/2016, and treated at the Cleveland Clinic were included. TET2 mutation data obtained by NGS (in the context of genomic panel) was also included. Results: Our dataset included 214 pts of median age 70 years (range 13-99), with 33%, 54%, and 12% having low, intermediate, and high risk MDS according to IPSS-R. Overall, 100 admissions for neutropenic fever were recorded with a median length of stay of 5 days per admission; 63 (29%) pts required at least one admission, and of these 9 (14%) pts required 3 or more (up to 6) admissions. Blood cultures were positive in 17 (27%) pts with common organisms including Staphylococcus (38%), Enterococcus (35%), and Pseudomonas (12%). Urine cultures were positive in 6 (10%) pts, with organisms including E. Coli (50%), Pseudomonas (17%) and Klebsiella (17%). Fungal work up was sent in 18 (29%) pts and was positive in 3 (17%) pts. 13 (21%) pts required ICU transfer, and of those 7 (51%) pts required vasopressor support, and 10 (77%) pts required mechanical ventilation. Median ICU length of stay was 3 days (range 1-26). 13 (21%) pts were discharged on IV antibiotics. Median OS for the entire cohort was 18 months (95% CI 7.9 – 34.7), and median OS for admitted patients was not significantly shorter at 48 or 65 months. The number of admissions for neutropenic fever, length of stay, IPSS-R risk category, TET2 mutation, and ICU transfer did not impact survival. Conclusions: The risk of admission for neutropenic fever was 29% with blood cultures positive in 27% of pts. TET2 mutation status and IPSS-R risk did not impact admission rate, length of stay or ICU transfer.