Low absolute CD4+ T cell counts in peripheral blood are associated with inferior survival in follicular lymphoma

Abstract

Host immunity and tumor microenvironment significantly influence follicular lymphoma (FL) outcomes. Lymphopenia has been identified as a negative prognostic factor for FL. However, there is limited data regarding prognostic value of peripheral blood T lymphocyte subsets, especially absolute CD4 T cell counts (ACD4C) in FL. We studied 127 consecutive FL patients to investigate whether peripheral blood ACD4C or absolute monocytes (AMC) at diagnosis had an impact on FL prognosis. In our cohort, both low ACD4C and high AMC were the parameters associated with inferior progression-free survival (PFS) (P = 0.021 and P = 0.013, respectively) and inferior overall survival (OS) (P = 0.020 and P = 0.005, respectively) by univariate analysis. Multivariate analysis revealed that only low ACD4C was statistically significant in worse PFS (hazard ratio, 2.811; 95 % confidence interval, 1.137-6.950; P = 0.025) and shorter OS (hazard ratio, 3.393; 95 % confidence interval, 1.037-11.105; P = 0.043) independent of FLIPI-2. Evaluation of blood ACD4C could be a useful indicator of outcome in previously untreated FL patients.

Use of peripheral lymphocytes and support vector machine for survival prediction in breast cancer patients

“…Previous studies showed that compared to normal people, cancer patients had decreased CD3+, CD4+ count, but elevated CD8+ count (11,12,(25)(26)(27). In addition, stage IV breast cancer and the Her-2/VEGF-positive breast cancer patients have worsened immune function (12) and poor survival prognosis.…”

Circulating Low Absolute CD4+ T Cell Counts May Predict Poor Prognosis in Extranodal NK/T-Cell Lymphoma Patients Treating with Pegaspargase-Based Chemotherapy

“…The tumor microenvironment has been shown to be a prognostic marker in certain types of lymphomas [17-20]. Regarding host immunity, several studies correlating circulating immune populations of peripheral blood cells with outcome in B-cell lymphoma have been reported [13,14,21]. Patients with decreased numbers of CD4 + T cells showed inferior OS and PFS.…”

“…A retrospective study of 127 FL patients revealed that low ACD4Cs were statistically significantly associated with a worse PFS and shorter OS. Evaluation of peripheral blood ACD4Cs could be a useful indicator of outcome in previously untreated FL patients [13]. Similarly, Zhang et al [14] reported that both low ACD4Cs and CD4/CD8 ratios were associated with unfavorable OS by univariate analysis.…”

“…Data are limited with respect to the role of specific circulating lymphocyte subsets in the progression of ENKTL patients, especially those treated with asparaginase-containing regimens [11,12]. Recent studies have suggested that there was a negative prognostic impact associated with low absolute CD4 + T-cell counts (ACD4Cs) in peripheral blood from follicular lymphoma (FL) and mantle cell lymphoma (MCL) patients [13,14]. Since the pathogenesis of ENKTL is strongly associated with immune cells infected with EBV, we speculated that host immune status might be linked to the prognosis of ENKTL.…”