Elevated neutrophil and monocyte counts in peripheral blood are associated with poor survival in patients with metastatic melanoma: a prognostic model.
Elevated neutrophil and monocyte counts in peripheral blood are associated with poor survival in patients with metastatic melanoma: a prognostic model.
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DOI：
10.1038/sj.bjc.6602702
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发表时间：
2005-08-08
影响因子：
8.8
通讯作者：
von der Maase, H
中科院分区：
文献类型：
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作者：
Schmidt, H;Bastholt, L;Geertsen, P;Christensen, I;Larsen, S;Gehl, J;von der Maase, H
我们的目标是根据 321 名接受白细胞介素 2 (IL-2) 免疫治疗的患者的独立预后因素创建转移性黑色素瘤的预后模型，目前患者的中位随访时间为 52 个月（范围 15-189 个月）。这些患者接受了多个 II 期方案的一部分治疗，大多数患者接受了中等剂量皮下 IL-2 和干扰素-α 的治疗。在单变量分析中，中性粒细胞和单核细胞计数、乳酸脱氢酶（LDH）、转移部位数量、转移位置和体能状态都是具有统计学意义的预后因素。随后，多变量 Cox 回归分析确定 LDH 升高（P<0.001，风险比 2.8）、中性粒细胞计数升高（P=0.02，风险比 1.4）和体能状态 2（P=0.008，风险比 1.6）作为生存不良的独立预后因素。单核细胞计数升高可以替代中性粒细胞计数升高。根据累积风险（定义为三个独立预后因素的简化风险评分之和），将患者分配到三个风险组之一。低风险、中风险和高风险患者的中位生存期分别为 12.6 个月（95% 置信区间 (CI)，11.4–13.8）、6.0 个月（95% CI，4.8–7.2）和 3.4 个月（95% CI，1.2–5.6）。低风险组涵盖了大多数长期幸存者，而预后极差的高风险组患者可能不应该接受基于 IL-2 的免疫治疗。
We aimed to create a prognostic model in metastatic melanoma based on independent prognostic factors in 321 patients receiving interleukin-2 (IL-2)-based immunotherapy with a median follow-up time for patients currently alive of 52 months (range 15–189 months). The patients were treated as part of several phase II protocols and the majority received treatment with intermediate dose subcutaneous IL-2 and interferon-α. Neutrophil and monocyte counts, lactate dehydrogenase (LDH), number of metastatic sites, location of metastases and performance status were all statistically significant prognostic factors in univariate analyses. Subsequently, a multivariate Cox's regression analysis identified elevated LDH (P<0.001, hazard ratio 2.8), elevated neutrophil counts (P=0.02, hazard ratio 1.4) and a performance status of 2 (P=0.008, hazard ratio 1.6) as independent prognostic factors for poor survival. An elevated monocyte count could replace an elevated neutrophil count. Patients were assigned to one of three risk groups according to the cumulative risk defined as the sum of simplified risk scores of the three independent prognostic factors. Low-, intermediate- and high-risk patients achieved a median survival of 12.6 months (95% confidence interval (CI), 11.4–13.8), 6.0 months (95% CI, 4.8–7.2) and 3.4 months (95% CI, 1.2–5.6), respectively. The low-risk group encompassed the majority of long-term survivors, whereas the patients in the high-risk group with a very poor prognosis should probably not be offered IL-2-based immunotherapy.
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影响因子：
5.5
作者：
Haghnegahdar, H;Du, JG;Richmond, A
通讯作者：
Richmond, A
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通讯作者：
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影响因子：
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通讯作者：
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