Absolute lymphocyte count recovery after induction chemotherapy predicts superior survival in acute myelogenous leukemia

Behl, Deepti; Porrata, Luis F.; Markovic, Svetomir N.; Letendre, Louis; Pruthi, Rajiv K.; Hook, C. Christopher; Tefferi, Ayalew; Elliot, Michelle; Kaufmann, Scott H.; Mesa, Ruben A.; Litzow, Mark R.

doi:10.1038/sj.leu.2404032

Cited by 111 publications

(80 citation statements)

References 13 publications

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“…Behl et al 15 demonstrated that ALC is predictive of outcome in older adults with AML (median age 59 years). Through comparison with our dataset, we observe that in our younger population (median age 18 years) ALC has a more dramatic predictive ability (HR 4.9 vs 2.1) and a lower ALC cutoff (350 vs 500 cells/lL).…”

Section: Discussion Alc Is An Independent Prognostic Indicator In Acumentioning

confidence: 99%

“…[11][12][13][14] These results suggest that rapid lymphocyte engraftment in these patients could increase a graft-versus-cancer effect and/or decrease morbidity related to poor engraftment. Interestingly, Behl et al 15 found that absolute lymphocyte counts (ALC) after induction chemotherapy predicts improved survival in adult patients with AML, suggesting that lymphocyte levels are critical in the nontransplant setting also. Two meeting abstracts suggested that lymphocyte counts after chemotherapy may also be predictive of survival in the pediatric age group.…”

Section: Lymphocytes In Cancermentioning

confidence: 99%

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

Angulo¹,

Yuen²,

Palla³

et al. 2007

Cancer

112

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BACKGROUND.Leukemia is the leading cause of disease‐related death in children, despite significant improvement in survival and modern risk stratification. The prognostic significance of absolute lymphocyte counts (ALC) was evaluated in young patients with acute myeloblastic leukemia (AML) and acute lymphoblastic leukemia (ALL).METHODS.In all, 171 consecutive de novo cases of AML and ALL, age ≤21 years, were analyzed. Age, initial white blood cell count, cytogenetics, and bone marrow response were compared with lymphocyte, neutrophil, and platelet counts at weekly intervals during induction chemotherapy.RESULTS.ALC is a significant independent predictor of relapse and survival. For example, in patients with AML an ALC on Day 28 of induction (ALC‐28) <350 cells/μL predicts very poor survival, with a 5‐year relapse‐free survival (RFS) of only 10% (hazard ratio [HR] 3.7, P = .003). In contrast, an ALC‐15 >350 cells/μL carries an excellent prognosis, with a 5‐year overall survival (OS) of 85% (HR 0.2, P = .012). Similarly in ALL, an ALC‐15 <350 cells/μL predicts poor survival, with a 6‐year RFS of 43% (HR 4.5, P = .002), whereas an ALC‐15 >350 cells/μL predicts excellent outcome, with a 6‐year OS of 87% (HR 0.2, P = .018). Importantly, ALC remains a strong predictor in multivariate analysis with known prognostic factors.CONCLUSIONS.ALC is a simple, statistically powerful measurement for patients with de novo AML and ALL. The results, when combined with previous studies, demonstrate that ALC is a powerful new prognostic factor for a range of malignancies. These findings suggest a need for further exploration of postchemotherapy immune status and immune‐modulating cancer therapies. Cancer 2008. © 2007 American Cancer Society.

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Section: Discussion Alc Is An Independent Prognostic Indicator In Acumentioning

confidence: 99%

Section: Lymphocytes In Cancermentioning

confidence: 99%

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

Angulo¹,

Yuen²,

Palla³

et al. 2007

Cancer

112

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“…For example, shift reconstitution of the immune system after induction regimens correlates with improved survival, and absolute leukocyte count is an independent prognostic factor for survival in patients with acute leukemia [14]. What is more, it is proven that malignant cells use multiple pathways to interfere the host immune system promoting the number and function of regulatory T cells (T regs) and subsequently reducing the ability of cytotoxic T cells to target leukemia [17].…”

Section: Rationale For Immunotherapy In Acute Leukemiamentioning

confidence: 99%

Immunotherapy in Pediatric Acute Leukemia: A Novel Magic Bullet or an Illusory Hope?

Barełkowska¹,

Derwich²

2017

Unique Aspects of Anti-Cancer Drug Development

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The last decade became the renaissance for investigating and exploring the potential role of immunotherapy in pediatric acute leukemia (AL). It is beyond question that there is an interaction between innate immune system and hematological malignancy. Leukemia cells inhibit the host immune response according to multiple mechanisms, but exploiting the innate immune system mechanisms can overcome the resistance to the conventional treatment. What is the role of immunotherapy in pediatric AL treatment? Does it have the potential to substitute or combine the standard chemotherapy? What is the best possible timing to take advantage of immune interventions? This review is considered to follow through the possible treatment options including their foundation, strong and weak points, but also information about possible implementation into the clinical practice.

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“…Similar expansions of immune cells have been observed in other hematological malignancies and this increase of immune cells has been associated with a better prognosis of patients. Thus, higher absolute lymphocyte count predicts higher survival in lymphoma, acute myeloblastic leukemia and myeloma (Cox et al, 2008;Siddiqui et al, 2006;Porrata et al, 2007Porrata et al, , 2009RayCoquard et al, 2009;De Angulo et al, 2008;Behl et al 2006Behl et al , 2007Ege et al, 2008). NK cell count has also been associated with clinical outcome in patients with diffuse large B-cell lymphoma (Plonquet et al, 2007).…”

Section: Immune Surveillance Of Chronic Lymphocytic Leukemiamentioning

confidence: 99%