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Absolute lymphocyte count at the time of first relapse predicts survival in patients with diffuse large B‐cell lymphoma
Author(s) -
Porrata Luis F.,
Ristow Kay,
Habermann Thomas M.,
Witzig Thomas E.,
Inwards David J.,
Markovic Svetomir N.
Publication year - 2009
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.21337
Subject(s) - lymphoma , medicine , diffuse large b cell lymphoma , lymphocyte , oncology , absolute neutrophil count , immunology , chemotherapy , neutropenia
Peripheral blood absolute lymphocyte count (ALC) is a survival prognostic factor in hematological malignancies. No reports have addressed whether ALC at the time of first relapse (ALC‐R) predicts survival. Thus, we assessed the prognostic significance of ALC‐R in diffuse large B‐cell lymphoma (DLBCL). Patients were required to have been diagnosed with first relapsed DLBCL, have ALC‐R values, and to be followed at Mayo Clinic, Rochester. From Feb 1987 until March 2006, 97 first relapsed DLBCL patients qualified for the study. The overall survival (OS) and progression‐free survival (PFS) were measured from the time of first relapse. The value of ALC‐ R ≥ 1.0 × 10 9 /L was used for the analysis. Both groups (ALC‐R ≥ 1 or < 1 × 10 9 /L) were balanced for the international prognostic index at relapse (IPI‐R) ( P = 0.3), and for autologous stem cell transplantation ( P = 0.4). Superior OS and PFS were observed with an ALC‐R ≥ 1.0 × 10 9 /L ( N = 60) versus ALC‐R < 1.0 × 10 9 /L ( N = 37) [median OS: 28.7 months, 5 years OS rates of 39% versus median OS: 10.2 months, 5 years OS rates of 14%, P < 0.002; and median PFS: 14.8 months, 5 years PFS rates of 21% versus median PFS: 6.5 months, 5 years PFS rates of 8%, P < 0.004, respectively]. ALC‐R was an independent prognostic factor for OS [RR = 0.4, P < 0.01] and PFS [RR = 0.5, P < 0.005]. ALC‐R predicts survival suggesting that host immunity is an important variable predicting survival in first relapsed DLBCL. Am. J. Hematol. 2009. © 2008 Wiley‐Liss, Inc.