Pre-treatment lymphopenia as a prognostic biomarker in colorectal cancer patients receiving chemotherapy
Pre-treatment lymphopenia as a prognostic biomarker in colorectal cancer patients receiving chemotherapy
复制标题
DOI：
10.1007/s00280-011-1610-3
复制
发表时间：
2011-11-01
影响因子：
3
通讯作者：
Lecomte, T.
中科院分区：
文献类型：
--
作者：
Ceze, N.;Thibault, G.;Lecomte, T.
淋巴细胞减少症是各种晚期癌症化疗疗效和血液学毒性的预测因子。关于结直肠癌中这种关系的数据很少。本回顾性研究共纳入260例结直肠癌患者，探讨化疗前淋巴细胞减少对血液学毒性和化疗疗效的影响。对治疗前淋巴细胞减少（淋巴细胞计数< 1,000/μ l）与一线姑息化疗的血液学毒性和疗效的关系进行了研究，发现49/260例（19%）患者出现淋巴细胞减少。这些淋巴细胞减少症患者中有10例（20.4%）发生了重度血液学毒性，而其余211例患者中有17例（8%）发生了重度血液学毒性（P = 0.01）。淋巴细胞减少症被确定为血液学毒性的独立因素。在接受姑息性化疗的患者中，淋巴细胞减少患者的客观缓解率显著低于其他患者（12.5% vs. 40.2%; P = 0.004）。淋巴细胞减少症与较短的无进展生存期（中位数4 vs 7个月; P = 0.033）和较短的总生存期（中位数16 vs 24个月，P = 0.024）密切相关。多因素分析显示淋巴细胞减少对生存率有独立影响，我们的研究结果显示淋巴细胞减少是结直肠癌化疗的血液学毒性和疗效的独立预测因素。治疗前淋巴细胞计数可能是结直肠癌患者化疗效果的一种简单而新的预测生物标志物。
Lymphopenia is a predictor of the efficacy and hematological toxicity of chemotherapy in various advanced cancers. There is little data about this relationship in colorectal cancer. In this retrospective study, the influence of pretreatment lymphopenia on hematological toxicity and the efficacy of chemotherapy was investigated in colorectal cancer patients.In total, 260 patients were included in the study. Correlations between pre-treatment lymphopenia (lymphocyte count < 1,000/mu l) and the occurrence of hematological toxicity and efficacy of first-line palliative chemotherapy were investigated.Lymphopenia was found in 49/260 (19%) patients. Ten of these patients with lymphopenia (20.4%) experienced severe hematological toxicity compared with 17 of the remaining 211 (8%) patients (P = 0.01). Lymphopenia was identified as an independent factor for hematological toxicity. Among patients who received palliative chemotherapy, the objective response rate was significantly lower in lymphopenic patients than in the other patients (12.5% vs. 40.2%; P = 0.004). Lymphopenia was strongly associated with shorter progression-free survival (median 4 vs. 7 months; P = 0.033) and shorter overall survival (median 16 vs. 24 months, P = 0.024). Multivariate analysis revealed that lymphopenia had an independent effect on survival.Our findings show that lymphopenia is an independent predictive factor for both hematological toxicity and efficacy of chemotherapy in colorectal cancer. Pre-treatment lymphocyte count may represent a simple and new predictive biomarker of chemotherapy effects in colorectal cancer patients.