Survival in Patients With Severe Lymphopenia Following Treatment With Radiation and Chemotherapy for Newly Diagnosed Solid Tumors

作者: Stuart A. Grossman , Susannah Ellsworth , Jian Campian , Aaron T. Wild , Joseph M. Herman

DOI: 10.6004/JNCCN.2015.0151

关键词: MedicineChemotherapyInternal medicineGliomaChemotherapy regimenChemoradiotherapySurgeryCarcinomaPancreatic cancerGastroenterologyHazard ratioCancer

摘要: BACKGROUND The immune system plays an important role in cancer surveillance and therapy. Chemoradiation can cause severe treatment-related lymphopenia (TRL) (<500 cells/mm3) that is associated with reduced survival. MATERIALS AND METHODS Data from 4 independent solid tumor studies on serial lymphocyte counts, prognostic factors, treatment, survival were collected analyzed. data set included 297 patients newly diagnosed malignant glioma (N=96), resected pancreatic (N=53), unresectable (N=101), non-small cell lung (N=47). RESULTS Pretreatment counts normal 83% of the patient population, no had baseline lymphopenia. Two months after initiating chemoradiation, 43% developed persistent (P=.001). An increased risk for death was attributable to TRL each cohort (gliomas: hazard rate [HR], 1.8; 95% CI, 1.13-2.87; pancreas: HR, 2.2; 1.17-4.12; unresected 2.9; 1.53-5.42; lung: 1.7; 0.8-3.61) entire study population regardless pathologic findings (HR, 2.1; 1.54-2.78; P<.0001). Severe observed more than 40% 2 histology or chemotherapy regimen, independently shorter progression. CONCLUSIONS Increased attention research should be focused cause, prevention, reversal this unintended consequence treatment seems related tumors.

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