Association between the Absolute Baseline Lymphocyte Count and Response to Neoadjuvant Platinum-based Chemotherapy in Muscle-invasive Bladder Cancer

Leibowitz-Amit, Raya; Israel, Ariel; Gal, Moran; Atenafu, Eshetu G.; Symon, Zvi; Portnoy, Orith; Laufer, Menachem; Dotan, Zohar; Ramon, Jacob; Avni, Dror; Fridman, Eduard; Berger, Raanan

doi:10.1016/j.clon.2016.07.007

Cited by 28 publications

(22 citation statements)

References 15 publications

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“…Recently, lymphopenia has been reported to be correlated with treatment response in certain solid tumors. Leibowitz‐Amit et al found that baseline lymphocyte counts were significantly associated with response to platinum‐based neoadjuvant chemotherapy in muscle‐invasive bladder cancer . Similarly, Kou et al found that pretreatment lymphopenia was associated with poor tumor response to first‐line chemotherapy in metastatic ESCC .…”

Section: Discussionmentioning

confidence: 99%

Lymphopenia in Esophageal Squamous Cell Carcinoma: Relationship to Malnutrition, Various Disease Parameters, and Response to Concurrent Chemoradiotherapy

Zhou

Zhu

et al. 2019

The Oncologist

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Background Lymphopenia occurs commonly in esophageal squamous cell carcinoma (ESCC) and may influence treatment outcomes. We aimed to examine its association with treatment response and tumor progression in patients with locally advanced ESCC treated with concurrent chemoradiotherapy (CCRT). Materials and Methods A total of 286 patients with stage II–IVa ESCC treated with CCRT between 2015 and 2017 were analyzed. Total lymphocyte counts were assessed at baseline, weekly, and 4 weeks after CCRT. Pretreatment lymphopenia was defined as total lymphocyte count <1,000 cells per mm3 at diagnosis, and treatment‐related lymphopenia was defined as total lymphocyte count <200 cells per mm3 with 6 weeks after starting CCRT. Univariate and multivariate logistic regression methods were used to analyze factors associated treatment‐related lymphopenia and treatment response. Results Lymphopenia was observed in 44 patients (15.4%) at initial diagnosis. Pretreatment lymphopenia was significantly associated with greater tumor length, worse T status, body mass index ≤18.5 kg/m2, and weight loss ≥3 kg in the previous 3 months. Six weeks after starting CCRT, 89 patients (31%) developed treatment‐related lymphopenia. Tumor progression and cancer‐related death were more frequently observed in treatment‐related lymphopenia group than those without (76.4% vs. 52.8% and 58.4% vs. 39.6%). A complete response (CR) was achieved in 62 patients (21.7%). In multivariate analysis, treatment‐related lymphopenia was significantly associated with lack of clinical CR, and older age, lower tumor location, greater tumor length, and larger planning target volume were independent predictors of treatment‐related lymphopenia. Conclusion Treatment‐related lymphopenia during CCRT is an independent predictor for poor treatment response in ESCC. Implications for Practice A total of 286 patients with locally advanced esophageal squamous cell carcinoma were treated with concurrent chemoradiotherapy (CCRT), and treatment‐related lymphopenia occurred in 31% of patients within 6 weeks from the start of CCRT. Treatment‐related lymphopenia was significantly associated with lack of treatment response, and older age, lower tumor location, greater tumor length, and larger planning target volume were independent predictors of treatment‐related lymphopenia. Lymphocyte count is an inexpensive biomarker that may be easily used by clinicians to identify patients who are most likely to benefit from CCRT.

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Section: Discussionmentioning

confidence: 99%

Lymphopenia in Esophageal Squamous Cell Carcinoma: Relationship to Malnutrition, Various Disease Parameters, and Response to Concurrent Chemoradiotherapy

Zhou

Zhu

et al. 2019

The Oncologist

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“…Absolute lymphocyte count was proven to be an independent prognostic factor in bladder cancer, melanoma and extranodal natural killer/T-cell lymphoma 8-10. Elevated monocyte count has been demonstrated to predict poor prognosis in mantle cell lymphoma, colorectal cancer and lung adenocarcinoma 11-13.…”

Section: Introductionmentioning

confidence: 99%

Peripheral blood lymphocyte-to-monocyte ratio as a prognostic factor in advanced epithelial ovarian cancer: a multicenter retrospective study

Zhu¹,

Liu²,

Wang³

et al. 2017

J. Cancer

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The lymphocyte-to-monocyte ratio (LMR), as a surrogate marker of systemic inflammation, has been found to be a novel prognostic indicator in various malignancies. Data from 672 advanced epithelial ovarian cancer (EOC) patients treated with neoadjuvant chemotherapy (NAC) followed by debulking surgery were analyzed, and the prognostic value of LMR were evaluated. The optimal cutoff point of LMR in prediction of survival was defined as 3.45 through receiver operating characteristics curve analysis. Patients with low LMR (≤3.45) at diagnosis tended to have more adverse clinical features, such as higher histological grade, chemotherapy resistance, and residual tumor >1cm after debulking surgery. No significant correlation was found between LMR level and age and histological type. Moreover, after NAC, the complete remission (CR) rate for the low-LMR group was lower than those for the high-LMR group (P<0.05). Patients with low LMR had poorer progression-free survival (PFS; P<0.001) and overall survival (OS; P<0.001). Multivariate analysis revealed that low LMR was an independent adverse predictor for PFS and OS. Results indicated that low LMR at diagnosis is a novel independent prognostic factor for advanced EOC. However, prospective study is needed to validate this prognostic factor and biological studies should further investigate the mechanisms underlying the correlation between low LMR and poor prognosis in advanced EOC.

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“…Furthermore, peripheral lymphocytes are known to be extremely sensitive to radiation despite mitotic inactivity (19), however, the mechanism underlying the observed lymphocyte reduction during RT is unclear. With regard to lymphocyte effects on patient outcomes, clinical studies have shown an association between higher lymphocyte levels and better patient outcomes (20,21). One of the largest of such studies was reported by Stanley et al (22), who analyzed 77 variables in 5,000 Veterans Affairs patients with inoperable NSCLC.…”

Section: Discussionmentioning

confidence: 96%

Does Lymphocyte-to-Monocyte Ratio Before, During, or After Definitive Chemoradiation for Locally Advanced Pancreatic Cancer Predict for Clinical Outcomes?

Scartoni

Giacomelli

Regine

et al. 2016

International Journal of Radiation Oncology*Biology*Physics

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Background: Elevated pre-treatment lymphocyte (L) to monocyte (M) ratio (LMR) in peripheral blood has been suggested to correlate with improved survival in some malignancies, but data in the context of pancreatic cancer (PC) is limited. The aim of this study was to evaluate the prognostic significance of LMR before, during and after definitive chemoradiotherapy (CRT) for locally advanced pancreatic cancer (LAPC). Conclusions: Factors significantly associated with overall survival (OS) and progression-free survival (PFS) were change in LMR at the end of CRT and absolute M count during CRT. This analysis suggests treatment-time-specific immune system parameters may affect clinical outcomes and warrant continued investigation.

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Association between the Absolute Baseline Lymphocyte Count and Response to Neoadjuvant Platinum-based Chemotherapy in Muscle-invasive Bladder Cancer

Cited by 28 publications

References 15 publications

Lymphopenia in Esophageal Squamous Cell Carcinoma: Relationship to Malnutrition, Various Disease Parameters, and Response to Concurrent Chemoradiotherapy

Lymphopenia in Esophageal Squamous Cell Carcinoma: Relationship to Malnutrition, Various Disease Parameters, and Response to Concurrent Chemoradiotherapy

Peripheral blood lymphocyte-to-monocyte ratio as a prognostic factor in advanced epithelial ovarian cancer: a multicenter retrospective study

Does Lymphocyte-to-Monocyte Ratio Before, During, or After Definitive Chemoradiation for Locally Advanced Pancreatic Cancer Predict for Clinical Outcomes?

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