TY - JOUR
T1 - Low absolute lymphocyte count is a poor prognostic marker in patients with diffuse large B-cell lymphoma and suggests patients' survival benefit from rituximab
AU - Oki, Yasuhiro
AU - Yamamoto, Kazuhito
AU - Kato, Harumi
AU - Kuwatsuka, Yachiyo
AU - Taji, Hirofumi
AU - Kagami, Yoshitoyo
AU - Morishima, Yasuo
N1 - Copyright:
Copyright 2009 Elsevier B.V., All rights reserved.
PY - 2008/12
Y1 - 2008/12
N2 - Objectives: To evaluate the prognostic value of absolute lymphocyte count (ALC) at diagnosis in patients with diffuse large B-cell lymphoma (DLBCL). Methods: In a large cohort of patients with DLBCL treated with CHOP (n = 119) or RCHOP (n = 102) in our institution, we evaluated the prognostic value of ALC at diagnosis with regards to treatment response, overall (OS) and progression-free survival (PFS). Use of rituximab, all International Prognostic Index (IPI) determinants, β2microglobulin level, presence of B symptoms or bulky disease, and ALC were evaluated. Results: Low ALC (<1.0 × 10 9/L) was associated with advanced stage, performance status ≥2, elevated lactate dehydrogenase, number of extranodal involvement ≥2, B symptoms, elevated β2microglobulin and higher IPI risk group. Low ALC was associated with lower CR rate by univariate analysis (odds ratio = 3.29, P = 0.024) but not by multivariate analysis. By univariate analysis using Cox proportional hazard model, low ALC was associated with shorter OS [hazard ratio (HR) = 2.89, P < 0.001] and PFS (HR = 2.91, P < 0.001). Multivariate analysis revealed that low ALC was associated with shorter OS (HR = 2.51, P = 0.003) and PFS (HR = 2.72, P < 0.001), independent of above-mentioned parameters. Subclass analyses revealed that the use of rituximab improves OS in patients with low ALC (HR = 0.42, P = 0.05) but not in those with high ALC (HR = 0.83, P = 0.71). This observation was most obvious in patients with higher IPI score. Conclusion: Low ALC is a poor prognostic marker in patients with DLBCL and suggests patients' survival benefit from rituximab.
AB - Objectives: To evaluate the prognostic value of absolute lymphocyte count (ALC) at diagnosis in patients with diffuse large B-cell lymphoma (DLBCL). Methods: In a large cohort of patients with DLBCL treated with CHOP (n = 119) or RCHOP (n = 102) in our institution, we evaluated the prognostic value of ALC at diagnosis with regards to treatment response, overall (OS) and progression-free survival (PFS). Use of rituximab, all International Prognostic Index (IPI) determinants, β2microglobulin level, presence of B symptoms or bulky disease, and ALC were evaluated. Results: Low ALC (<1.0 × 10 9/L) was associated with advanced stage, performance status ≥2, elevated lactate dehydrogenase, number of extranodal involvement ≥2, B symptoms, elevated β2microglobulin and higher IPI risk group. Low ALC was associated with lower CR rate by univariate analysis (odds ratio = 3.29, P = 0.024) but not by multivariate analysis. By univariate analysis using Cox proportional hazard model, low ALC was associated with shorter OS [hazard ratio (HR) = 2.89, P < 0.001] and PFS (HR = 2.91, P < 0.001). Multivariate analysis revealed that low ALC was associated with shorter OS (HR = 2.51, P = 0.003) and PFS (HR = 2.72, P < 0.001), independent of above-mentioned parameters. Subclass analyses revealed that the use of rituximab improves OS in patients with low ALC (HR = 0.42, P = 0.05) but not in those with high ALC (HR = 0.83, P = 0.71). This observation was most obvious in patients with higher IPI score. Conclusion: Low ALC is a poor prognostic marker in patients with DLBCL and suggests patients' survival benefit from rituximab.
KW - Absolute lymphocyte count
KW - Diffuse large B-cell lymphoma
KW - Prognostic factor
KW - Rituximab
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U2 - 10.1111/j.1600-0609.2008.01129.x
DO - 10.1111/j.1600-0609.2008.01129.x
M3 - Article
C2 - 18691256
AN - SCOPUS:56649121692
SN - 0902-4441
VL - 81
SP - 448
EP - 453
JO - European Journal of Haematology
JF - European Journal of Haematology
IS - 6
ER -