Absolute lymphocyte count is a novel prognostic indicator in ALL and AML

Angulo, Guillermo De; Yuen, Carrie; Palla, Shana L.; Anderson, Peter M.; Zweidler‐McKay, Patrick A.

doi:10.1002/cncr.23168

Cited by 112 publications

(88 citation statements)

References 42 publications

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“…The results obtained in the current study confirm the observations of other authors [3,5,6,11,13,17,19] that after ALL treatment children are in an immunocompromised state for up to 12 months. This concerns both cellular and humoral immunity.…”

Section: Discussionsupporting

confidence: 92%

The Recovery of Immune System Parameters in Children Following Lymphoblastic Leukemia Therapy – Preliminary Report

Pietras¹,

Chaber²,

Pela³

et al. 2014

Adv Clin Exp Med

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Background. Acute lymphoblastic leukemia (ALL) is the most common pediatric neoplasm. Long-term survival is achieved in approximately 80% of patients. One of the more common complications of ALL treatment is immunosuppression. Objectives. The aim of the study is to assess the reconstruction rate of the most important immune system parameters in children after ALL treatment. Material and Methods. The study included 47 children (22 boys, 25 girls) diagnosed and treated for ALL in Department of Pediatric Hematology and Oncology at Wroclaw Medical University. The study used peripheral blood collected at the time treatment was completed and in the first, second, third and sixth months following treatment, then at yearly intervals up to 10 years after treatment. In order to determine the immune status of the tested samples the following parameters were assessed: white blood cell count, absolute lymphocyte count, the proportions of individual subpopulations of lymphocytes -T (CD3 +), Th (CD4 +), Ts (CD8 +), B (CD19 +), NK (CD16 + 56 +), the concentration of immunoglobulins A, G and M, interleukin 10 activity, as well as the expression of ICAM-1 adhesion molecules. Results. At the end of anti-neoplastic therapy a reduction in both the absolute number leukocytes and various subpopulations of lymphocytes was observed. The lower limits of normal range were achieved about two years after the end of treatment. The concentrations of immunoglobulin IgA, IgG and IgM at the end of treatment were within low normal limits. Normal concentrations of immunoglobulin levels and stability were observed about two years after the end of treatment. There was a slow, steady increase in the production of interleukin-10 and the expression of ICAM-1 adhesion molecules. These results confirm previous observations that after ALL treatment children are in an immunocompromised state for up to 12 months, in terms of both humoral and cellular immunity. Conclusions. Knowing the average growth trends for the main immune system parameters after ALL treatment can be important in clinical practice for children in whom immune reconstruction proceeds slowly. Predicting the expected time required to restore immune function could be of help, for example in combating infections and planning vaccinations (Adv Clin Exp Med 2014, 23, 1, 97-102).

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Section: Discussionsupporting

confidence: 92%

The Recovery of Immune System Parameters in Children Following Lymphoblastic Leukemia Therapy – Preliminary Report

Pietras¹,

Chaber²,

Pela³

et al. 2014

Adv Clin Exp Med

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“…30,36,37 Antecedent evidence verified that ALC and AMC were parameters to predict outcomes in several types of cancer. [14][15][16][17][18][19][20][38][39][40][41][42] ALC and AMC have been studied as combined factors in Hodgkin's lymphoma and diffuse large B-cell lymphoma. 19,[21][22][23][24][25][26] Results showed that ALC/AMC ratio and AMC/ALC prognostic scores seemed to be associated with outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies showed that absolute lymphocyte count (ALC) [14][15][16][17][18][19] and peripheral blood absolute monocyte count (AMC) 19,20 at diagnosis can evaluate the prognosis in some lymphoid and hematological malignancies. Moreover, the value of the incorporation of ALC and AMC has been explored and several studies revealed that ALC/AMC ratio [21][22][23][24] and ALC/AMC prognostic score (low risk and normal ALC and AMC; intermediate risk, low ALC, or high AMC; high risk, low ALC, and high AMC) 19,25,26 were related to survival in certain types of lymphomas.…”

Section: Introductionmentioning

confidence: 99%

Prognostic impact of absolute lymphocyte count/absolute monocyte count ratio and prognostic score in patients with nasal-type, extranodal natural killer/T-cell lymphoma

Zhang

Song

et al. 2017

Tumour Biol.

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Nasal-type, extranodal natural killer/T-cell lymphoma is a heterogeneous disorder with poor prognosis, requiring risk stratification in this population. The combined value of baseline absolute lymphocyte count and absolute monocyte count provided prognostic information in some malignancies. However, the evidence requires validation in extranodal natural killer/T-cell lymphoma. Aiming to investigate the prognostic significance of absolute lymphocyte count/absolute monocyte count ratio and absolute lymphocyte count/absolute monocyte count prognostic score for extranodal natural killer/Tcell lymphoma, a retrospective research was carried out. A total of 264 patients with newly diagnosed extranodal natural killer/T-cell lymphoma were analyzed in this study. The patients' absolute lymphocyte count and absolute monocyte count tested at initial diagnosis were collected. Receiver operating curve analysis showed that the optimal cut-off values for absolute lymphocyte count and absolute monocyte count were 1.0 × 10 9 and 0.5 × 10 9 L −1 , respectively, and for absolute lymphocyte count/absolute monocyte count ratio was 2.85. After a median follow-up of 27 months (range 1-87 months), the 3-year overall survival and progression-free survival was 75.4% and 67.6%, respectively. Patients with absolute lymphocyte count/absolute monocyte count ratio ≥ 2.85 had better 3-year overall survival and progressionfree survival than those with absolute lymphocyte count/absolute monocyte count ratio <2.85 (p < 0.001). According to absolute lymphocyte count/absolute monocyte count prognostic score, significant difference has been noticed in 3-year overall survival and progression-free survival (p < 0.001) and high absolute lymphocyte count/absolute monocyte count prognostic score was associated with poorer survival. The International Prognostic Index and Korean Prognostic Index were used for prognosis and showed no significant difference. When adding absolute lymphocyte count/absolute monocyte count ratio and absolute lymphocyte count/absolute monocyte count prognostic score to the International Prognostic Index and Korean Prognostic Index model, additional prognostic information was found. These results suggest that absolute lymphocyte count/absolute monocyte count ratio and absolute lymphocyte count/absolute monocyte count prognostic score might be useful prognostic factors in extranodal natural killer/T-cell lymphoma.

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“…The third center administered post-HSCT i.t. therapy to all ALL patients and to high-risk AML patients where the AML patients generally considered to be high risk were AML FAB M4-M7 and AML FAB M0-M3 patients with a high presenting leukocyte count (WBC) (420 Â 10 9 /L) or another high-risk factor such as extramedullary involvement or slow response to primary treatment [8][9][10] (Table 1). The fourth center gave i.t.…”

Section: Patient Characteristicsmentioning

confidence: 99%

Use of intrathecal chemoprophylaxis in children after SCT and the risk of central nervous system relapse

Vettenranta

et al. 2010

Bone Marrow Transplant

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Conflicting conclusions can be drawn from the available data concerning antileukemic efficacy and risks of intrathecal (i.t.) chemoprophylaxis to children after hematopoietic SCT (HSCT). To address this, we enrolled six transplantation centers with similar treatment and patient material. Of the 397 children included, 136 patients had received post-HSCT i.t. treatment (i.t. group) and 261 had not (non-i.t. group). The two groups were, apart from the i.t. therapy given or not given, at equal risk of post-HSCT central nervous system (CNS) relapse, which was the primary endpoint studied. Isolated CNS relapses were observed in 2 (1.5%) patients from the i.t. group and 2 (1%) from the non-i.t. group. Combined relapses, including CNS, involved 4 (3%) patients from the i.t. group and 6 (2%) from the non-i.t. group. Overall survival and the occurrence of neurological side effects did not differ significantly between the groups. There was no statistically significant difference in the incidence of isolated or mixed CNS relapses between the two groups, suggesting little or no benefit from i.t. therapy post-HSCT in children.

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Absolute lymphocyte count is a novel prognostic indicator in ALL and AML

Cited by 112 publications

References 42 publications

The Recovery of Immune System Parameters in Children Following Lymphoblastic Leukemia Therapy – Preliminary Report

The Recovery of Immune System Parameters in Children Following Lymphoblastic Leukemia Therapy – Preliminary Report

Prognostic impact of absolute lymphocyte count/absolute monocyte count ratio and prognostic score in patients with nasal-type, extranodal natural killer/T-cell lymphoma

Use of intrathecal chemoprophylaxis in children after SCT and the risk of central nervous system relapse

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