Incidental lymphopenia and mortality: a prospective cohort study

Abstract

L ymphopenia in an otherwise healthy person is typically discovered when doing routine blood counts. In Denmark, patients with incidental lymphopenia are usually not referred for further examination because the mortality implications are unknown. In general, predictors of mortality are highly valued in everyday clinical practice because they help identify patients who may benefit from additional medical attention. Observational studies have shown lymphopenia to be associated with risk of cardiovascular disease, 1-5 cancer, 6-11 liver disease (including alcohol abuse disorders) 12,13 and systemic autoimmune disease. 14-16 In a 2018 study involving 98 344 participants from the general population of Denmark, we found that lymphopenia was associated with a high risk of infectious disease. 17 The risk of all-cause mortality for patients with incidental lymphopenia is not known. This study aimed to identify the associations between lymphopenia and all-cause and cause-specific mortality. Methods We followed the reporting standards outlined in the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. 18 Study design and participants Participants who were white, of Danish descent and aged 20-100 years were eligible if they participated in the Copenhagen General Population Study, 17 a prospective cohort study that enrolled participants from November 2003 to April 2015 from suburbs in and around Copenhagen, Denmark. 19-21 Further details can be found in Appendix 1, Supplementary Methods,

Prognostic Value of Pretreated Blood Inflammatory Markers in Patients with Bone Sarcoma: A Meta-Analysis

“…Elevated lymphocyte infiltration in the tumor site has been suggested to be associated with favorable outcomes [ 37 , 38 ]. In contrast, lymphopenia implied the impairment of the host immune response to tumor and was reported to be correlated with the severity of diseases [ 39 , 40 ]. Because of all this background of the inflammatory response, inflammation-based prognostic indicators have emerged in the clinical management of patients with cancer.…”

Low-Blood Lymphocyte Number and Lymphocyte Decline as Key Factors in COPD Outcomes: A Longitudinal Cohort Study

“…The assessment of the effects of BL number and BL decline on all-cause mortality showed that subjects with low-BL and BL decline had a significantly higher mortality than subjects with high BL and no decliners. A recent large population study reporting an important association of mortality with BL count, confirms that mortality starts increasing when BL values are below 1,800 cells/µL [26].…”

“…BL number in normal populations (range 1,100–4,800, median 2,100 cells/µL) exhibits a great degree of interindividual variation, and it is unclear whether these differences are due to individual’s characteristics that remain stable with aging or to possible environmental or other factors [23, 26]. The distribution of absolute BL number in our population is in keeping with the known normal BL variability; however, COPD had a systematic reduction in BL number and, as a result, 43% of COPD had low-BL (<1,800 cells/µL) compared to only 23% noCOPD.…”

Lymphopenia and mortality among patients undergoing coronary angiography: Long-term follow-up study

“…Early studies have shown that a low relative lymphocyte count, measured as the percentage of total leukocytes, is predictive of adverse outcomes in CVD states, particularly heart failure [6][7][8][9][10]. Relatively few studies have evaluated absolute lymphocyte count as a prognostic biomarker, recently demonstrated to risk stratify for mortality in the general population setting [11,12]. Our findings extend the prognostic value of absolute lymphopenia to patients undergoing coronary angiography for evaluation and/or treatment of CAD with both acute and non-acute coronary syndromes.…”