Longitudinal analysis of complete blood count parameters in advanced‐stage lung cancer patients

Abstract

Background Metastatic lung cancer is a debilitating disease, but with the advances in immunotherapy, therapeutic options have vastly increased. Numerous complete blood count parameters (CBC) have been described as easily accessible biomarkers that might predict response to immunotherapy. However, to date, no comprehensive study has been performed on the longitudinal changes of these parameters during cancer progression. Methods The clinicopathological variables and CBC parameters of 986 advanced stage lung cancer patients were retrospectively analyzed. Blood tests were performed as part of the routine checkup and the results were recorded at the time of the diagnosis of the primary tumor, the diagnosis of brain or bone metastases, and also during the last available follow‐up. Results In the experimental subcohort, 352 and 466 patients were diagnosed with brain and bone metastases, respectively. The control group consisted of 168 patients without clinically detectable or other distant organ metastases. In our longitudinal analyses, we found significantly decreasing absolute lymphocyte count (ALC: P < 0.001), and significantly increasing absolute neutrophil count (ANC: P < 0.001) levels in all patient subgroups, irrespective of histopathological type and metastatic site. Interestingly, patients with brain metastases had significantly descending‐ascending platelet count (PLT) trendlines ( P < 0.001), while the bone metastatic subgroup exhibited significantly ascending‐descending trendlines ( P = 0.043). Conclusions Significantly decreasing ALC, significantly increasing ANC and fluctuating PLT levels may be found in brain and bone metastatic lung cancer patients during disease progression. Our findings might contribute to improve personalized healthcare in this devastating malignancy. Key points Significant findings of the study Significantly decreasing ALC, and significantly increasing ANC levels can be found in advanced‐stage lung cancer patients during disease progression Patients with brain metastases have descending‐ascending PLT trendlines, while patients with bone metastases exhibit ascending‐descending trendlines during disease progression What this study adds The descending values for ALC, and the ascending mean values for PLT and ANC, might be suggestive of poor response to second‐ or third‐line immunotherapy in advanced‐stage lung cancer patients. The current study might help to improve patient selection and treatment strategies for brain and/or bone metastatic lung cancer patients.

Evaluation of some hematological criteria in lung cancer patients

“…As shown in Table 2, the present study revealed a significant elevation in the total white blood cells and neutrophils in lung cancer patients compared to healthy subjects, while there was a significant decrease in lymphocytes. Our findings are consistent with those of other studies (Mandrekar et al, 2006;Wong et al, 2019;Rojko et al, 2020).…”

“…This study's findings revealed a significant increase in platelet count and MPV in patients with lung cancer in comparison with control groups (Table 2). The findings of our study are in agreement with those obtained by other investigations (Omar et al, 2016;Zhu et al, 2019;Rojko et al, 2020). Also, having a high number of platelets has been linked to the progression of other cancers, such as rectal cancer (Andronic et al, 2019) and breast cancer (Ali et al, 2020).…”

“…Elevated NLR is associated with systemic and local inflammation that not only provides a favorable microenvironment for tumor invasion and metastasis but also suppresses the host immune system (Luo et al, 2015). It is hypothesized that inflammation is linked to the prognosis of SCLC, and that NLR or PLR may be useful markers of the inflammatory process (Rojko et al, 2020). An elevated NLR at the time of diagnosis was associated with a poor performance status, an advanced disease stage, and a low response rate.…”

“…For hematological assessment, the venous blood was taken from the cubital vein of resting patients and a healthy group in the morning using a disposable syringe. One ml of each blood sample was placed in an EDTA tube for measurement of hematological parameters (erythrocyte, leukocyte, and thrombocyte indices) (Rojko et al, 2020). The routine automated method for the complete blood count (CBC) was used to determine the hematological parameters (erythrocyte, leukocyte, and thrombocyte indices).…”

“…Consequently, investigating the continuous changes in CBC indices during cancer growth may provide significant information on anticipated therapeutic efficacy, thereby aiding doctors in the creation of new treatment regimens (Rojko et al, 2020). The current study aims to evaluate the levels of some erythrocyte, leukocyte, and thrombocyte indices in the serum of patients with lung cancer.…”