Association between severe treatment-related lymphopenia and progression-free survival in patients with newly diagnosed squamous cell head and neck cancer.
Association between severe treatment-related lymphopenia and progression-free survival in patients with newly diagnosed squamous cell head and neck cancer.
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DOI：
10.1002/hed.23535
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发表时间：
2014-12
影响因子：
2.9
通讯作者：
Grossman, Stuart A.
中科院分区：
文献类型：
--
作者：
Campian, Jian L.;Sarai, Guneet;Ye, Xiaobu;Marur, Shanthi;Grossman, Stuart A.
关键词：
严重的治疗相关淋巴细胞减少症（TRL）常见于许多癌症中，并且与早期肿瘤进展相关。目前缺乏关于鳞状细胞头/颈癌是否发生这种情况的数据。对新诊断的鳞状头颈癌接受放化疗的患者的系列总淋巴细胞计数（TLC）进行回顾性分析，并将其与治疗结果相关。 56 名患者的中位基线 TLC 为 1660 个细胞/mm3，开始放化疗两个月后下降 73% 至 445 个细胞/mm3 (p<0.0001)。两个月时 TLC<500 个细胞/mm3 的 HPV− 患者比 TLC 较高的患者明显更早出现疾病进展（HR 5.75，p=0.045）。基线 TLC 正常，但两个月后，无论 HPV 状态如何，约 60% 的患者出现严重 TRL。 HPV− 患者中的严重 TRL 与早期疾病进展独立相关。需要前瞻性研究来证实这些发现，表明免疫保存在这种癌症中很重要。
Severe treatment-related lymphopenia (TRL) occurs commonly in many cancers and is associated with early tumor progression. Data is lacking as to whether this occurs in squamous cell head/neck cancer. Serial total lymphocyte counts (TLC) were retrospectively reviewed in patients with newly diagnosed squamous head and neck cancer undergoing chemoradiation and associated with treatment outcomes. The median baseline TLC in 56 patients was 1660 cells/mm3 which fell by 73% to 445 cells/mm3 two months after initiating chemoradiation (p<0.0001). HPV− patients with TLC<500 cells/mm3 at two months had significantly earlier disease progression than those with higher TLCs (HR 5.75, p=0.045). Baseline TLCs were normal but at two months ~60% of patients had severe TRL regardless of HPV status. Severe TRL in HPV− patients is independently associated with earlier disease progression. Prospective studies are needed to confirm these findings which suggest that immune preservation is important in this cancer.
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