Lymphopenia as a prognostic factor for overall survival in advanced carcinomas, sarcomas, and lymphomas.
Lymphopenia as a prognostic factor for overall survival in advanced carcinomas, sarcomas, and lymphomas.
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DOI：
10.1158/0008-5472.can-08-3845
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发表时间：
2009-07-01
期刊：
影响因子：
11.2
通讯作者：
European Organization for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group
中科院分区：
文献类型：
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作者：
Ray-Coquard I;Cropet C;Van Glabbeke M;Sebban C;Le Cesne A;Judson I;Tredan O;Verweij J;Biron P;Labidi I;Guastalla JP;Bachelot T;Perol D;Chabaud S;Hogendoorn PC;Cassier P;Dufresne A;Blay JY;European Organization for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group
淋巴细胞减少症在晚期癌症中很常见，可以预测化疗的毒性。它对复发和生存的影响尚不确定。其生存预后价值在先前报道的前瞻性多中心研究的 3 个数据库中进行了分析：1) FEC 化疗在转移性乳腺癌中的应用； 2) CYVADIC 治疗晚期软组织肉瘤 (EORTC-STBSG 62791)； 3) 1987 年至 1993 年间在 Bérard 中心进行的侵袭性弥漫性大细胞非霍奇金淋巴瘤前瞻性连续 III 期研究。对生存预后因素进行了单变量和多变量分析。治疗前淋巴细胞减少<1000/μL的发生率在各系列中保持不变：分别为25%、24%、27%。体力状态（PS）> 1的转移性乳腺癌患者、国际预后指数（IPI）> 0的非霍奇金淋巴瘤患者以及晚期软组织肉瘤和骨转移的转移性乳腺癌患者中，淋巴细胞减少症的发生率显着更高（p<0.05）。在单变量分析中，淋巴细胞减少症 <1000/μL 与转移性乳腺癌（中位 10 个月与 14 个月，p <0.0001）、晚期软组织肉瘤（中位 5 个月与 10 个月，p <0.01）和非霍奇金淋巴瘤（中位 11 与 94 个月，p <0.0001）患者的总生存率显着相关。在多变量分析（Cox 模型）中，淋巴细胞减少症与肝转移和 PS 一样，是转移性乳腺癌总体生存的独立预后因素（RR：1.8；95%CI 1.3-2.4）；晚期软组织肉瘤（RR：1.46；95%CI 1.0-2.1）以及肝转移、肺转移和 PS；以及与 IPI 一起用于非霍奇金淋巴瘤（RR：1.48；95%CI 1.03-2.1）。我们的研究结果表明，淋巴细胞减少症是多种癌症总体生存期和无进展生存期的独立预后因素。
Lymphopenia is frequent in advanced cancers and predicts the toxicity of chemotherapy. Its impact on relapse and survival is uncertain. Its prognostic value for survival was analyzed in 3 databases of previously reported prospective multicenter studies: 1) FEC chemotherapy in metastatic breast carcinoma; 2) CYVADIC in advanced soft-tissue sarcoma (EORTC-STBSG 62791); 3) prospective, consecutive phase III studies of aggressive diffuse large-cell non-Hodgkin’s lymphomas conducted at Bérard center between 1987 and 1993. Univariate and multivariate analyses of prognostic factors for survival were performed. The incidence of lymphopenia <1000/μL before treatment was constant among series: 25%, 24%, 27% respectively. Lymphopenia was significantly more frequent (p<0.05) in metastatic breast cancer patients with performance status (PS)>1, non-Hodgkin’s lymphoma patients with international prognostic index (IPI)>0, and advanced soft-tissue sarcoma and metastatic breast cancer patients with bone metastases. In univariate analysis, lymphopenia <1000/μL significantly correlated to overall survival in patients with metastatic breast cancer (median 10 vs. 14 months, p <0.0001), advanced soft-tissue sarcoma (median 5 vs. 10 months, p <0.01), and non-Hodgkin lymphoma (median 11 vs. 94 months, p <0.0001). In multivariate analysis (Cox model), lymphopenia was an independent prognostic factor for overall survival in metastatic breast cancer (RR: 1.8; 95%CI 1.3–2.4) along with liver metastases and PS; in advanced soft-tissue sarcoma (RR: 1.46; 95%CI 1.0–2.1) along with liver metastases, lung metastases and PS; and in non-Hodgkin’s lymphoma (RR: 1.48; 95%CI 1.03–2.1) along with IPI. Our findings demonstrate that lymphopenia is an independent prognostic factor for overall and progression-free survival in several cancers.