Lymphopenia as a Prognostic Factor for Overall Survival in Advanced Carcinomas, Sarcomas, and Lymphomas
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- Isabelle Ray-Coquard
- 1Université de Lyon-Centre Léon Bérard, Department of Medical Oncology and EA SIS 4128, Lyon, France;
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- Claire Cropet
- 2Université de Lyon-Centre Léon Bérard, Department of Statistics, Lyon, France;
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- Martine Van Glabbeke
- 3European Organization for Research and Treatment of Cancer Headquarters, Brussels, Belgium;
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- Catherine Sebban
- 1Université de Lyon-Centre Léon Bérard, Department of Medical Oncology and EA SIS 4128, Lyon, France;
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- Axel Le Cesne
- 4Institut Gustave Roussy, Villejuif, France;
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- Ian Judson
- 5Royal Marsden Hospital, London, United Kingdom;
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- Olivier Tredan
- 1Université de Lyon-Centre Léon Bérard, Department of Medical Oncology and EA SIS 4128, Lyon, France;
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- Jaap Verweij
- 6Erasmus University Medical Center, Rotterdam, The Netherlands;
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- Pierre Biron
- 1Université de Lyon-Centre Léon Bérard, Department of Medical Oncology and EA SIS 4128, Lyon, France;
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- Inthidar Labidi
- 1Université de Lyon-Centre Léon Bérard, Department of Medical Oncology and EA SIS 4128, Lyon, France;
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- Jean-Paul Guastalla
- 1Université de Lyon-Centre Léon Bérard, Department of Medical Oncology and EA SIS 4128, Lyon, France;
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- Thomas Bachelot
- 1Université de Lyon-Centre Léon Bérard, Department of Medical Oncology and EA SIS 4128, Lyon, France;
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- David Perol
- 2Université de Lyon-Centre Léon Bérard, Department of Statistics, Lyon, France;
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- Sylvie Chabaud
- 2Université de Lyon-Centre Léon Bérard, Department of Statistics, Lyon, France;
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- Pancras C.W. Hogendoorn
- 7Leiden University Medical Center, Leiden, The Netherlands;
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- Philippe Cassier
- 8UJOMM, Hopital Edouard Herriot, Lyon, France; and
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- Armelle Dufresne
- 8UJOMM, Hopital Edouard Herriot, Lyon, France; and
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- Jean-Yves Blay
- 8UJOMM, Hopital Edouard Herriot, Lyon, France; and
説明
<jats:title>Abstract</jats:title> <jats:p>Lymphopenia is frequent in advanced cancers and predicts the toxicity of chemotherapy. Its effect on relapse and survival is uncertain. Its prognostic value for survival was analyzed in three databases of previously reported prospective multicenter studies: (a) FEC chemotherapy in metastatic breast carcinoma; (b) CYVADIC in advanced soft tissue sarcoma (European Organization for Research and Treatment of Cancer–Soft Tissue and Bone Sarcoma Group 62791); and (c) prospective, consecutive phase III studies of aggressive diffuse large-cell non–Hodgkin's lymphomas conducted at Centre Léon Bérard between 1987 and 1993. Univariate and multivariate analyses of prognostic factors for survival were performed. The incidence of lymphopenia of <1,000/μL before treatment was constant among the series: 25%, 24%, and 27%, respectively. Lymphopenia was significantly more frequent (P < 0.05) in metastatic breast cancer patients with performance status (PS) of >1, non–Hodgkin's lymphoma patients with international prognostic index (IPI) of > 0, and advanced soft tissue sarcoma and metastatic breast cancer patients with bone metastases. Inunivariate analysis, lymphopenia of <1,000/μL significantly correlated to overall survival in patients with metastatic breast cancer (median, 10 versus 14 mo; P < 0.0001), advanced soft tissue sarcoma (median, 5 versus 10 months; P < 0.01), and non–Hodgkin lymphoma (median, 11 versus 94 months; P < 0.0001). In multivariate analysis (Cox model), lymphopenia was an independent prognostic factor for overall survival in metastatic breast cancer [RR (relative risk), 1.8; 95% CI (confidence interval), 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 show that lymphopenia is an independent prognostic factor for overall and progression-free survival in several cancers. [Cancer Res 2009;69(13):5383–91]</jats:p>
収録刊行物
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- Cancer Research
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Cancer Research 69 (13), 5383-5391, 2009-07-01
American Association for Cancer Research (AACR)