Absolute lymphocyte count at the time of first relapse predicts survival in patients with diffuse large B-cell lymphoma

摘要

Peripheral blood absolute lymphocyte count (ALC) is a survival prognostic factor in hematological malig-nnancies. No reports have addressed whether ALC at the time of first relapse (ALC-R) predicts survival.nThus, we assessed the prognostic significance of ALC-R in diffuse large B-cell lymphoma (DLBCL). Patientsnwere required to have been diagnosed with first relapsed DLBCL, have ALC-R values, and to be followed atnMayo Clinic, Rochester. From Feb 1987 until March 2006, 97 first relapsed DLBCL patients qualified for thenstudy. The overall survival (OS) and progression-free survival (PFS) were measured from the time of firstnrelapse. The value of ALC-R u0001 1.0 3 109n/L was used for the analysis. Both groups (ALC-R u0001 1or < 1 3 109nL) were balanced for the international prognostic index at relapse (IPI-R) (P 5 0.3), and for autologous stemncell transplantation (P 5 0.4). Superior OS and PFS were observed with an ALC-R u0001 1.0 3 109n/L (N 5 60)nversus ALC-R < 1.0 3 109n/L (N 5 37) [median OS: 28.7 months, 5 years OS rates of 39% versus median OS:n10.2 months, 5 years OS rates of 14%, P < 0.002; and median PFS: 14.8 months, 5 years PFS rates of 21%nversus median PFS: 6.5 months, 5 years PFS rates of 8%, P < 0.004, respectively]. ALC-R was an independ-nent prognostic factor for OS [RR 5 0.4, P < 0.01] and PFS [RR 5 0.5, P < 0.005]. ALC-R predicts survivalnsuggesting that host immunity is an important variable predicting survival in first relapsed DLBCL. Am. J.nHematol. 84:93–97, 2009. V V C 2008 Wiley-Liss, Inc.