The relationship between absolute lymphocyte count with PFS in patients with Hodgkin's lymphoma undergoing autologous hematopoietic cell transplant

Abstract

Previous reports in Hodgkin's lymphoma (HL) patients undergoing autologous hematopoietic cell transplantation (AHCT) have demonstrated a significant association between the absolute lymphocyte count at day 15 (ALC-15) with survival. To evaluate this finding further, we analyzed 146 patients with relapsed/refractory HL who underwent AHCT to evaluate the relationship between lymphocyte counts at apheresis and at two time points (days 15 and 90) after AHCT with PFS. We found no association between the ALC-15 and the ALC-90 with PFS. We found lymphocyte counts at apheresis and disease sensitive to salvage chemotherapy were predictive of PFS. In conclusion, our study does provide some support for the theory that the immune system may be important in disease control but further and more detailed studies in this area are required.

Pretreatment T Lymphocyte Numbers Are Contributing to the Prognostic Significance of Absolute Lymphocyte Numbers in B-cell Non-Hodgkins Lymphomas

“…This was proven to be an independent prognostic factor in follicular lymphoma and DLBCL [4,13]. It has been validated as having prognostic value in Hodgkin's lymphoma [15] and acute myeloid leukemias as well [16]. It is very important to further categorize lymphocyte populations, as it is a dynamically changing population, consisting of several major cell types.…”

Improving the international prognostic index score using peripheral blood counts: Results of a large multicenter study involving 520 patients with diffuse large B cell lymphoma

“…In recent years a growing amount of research has shown that tumour microenvironment, host immunity, and inflammatory responses all play an important role in determining survival outcome of lymphoma. In this respect some have considered AMC as a surrogate biomarker of tumour‐associated macrophages within the tumour microenvironment 20 while others have regarded ALC as an important biomarker of tumour infiltrating lymphocytes (TILs) reflecting host immunity status, 21 and others have regarded ANC as a measure of the systemic inflammatory response to the tumor 22 . In this respect, inflammation is considered as a critical component of tumour progression, and it is evident that the tumour microenvironment, is largely coordinated by inflammatory cells, which play a central role in the neoplastic process by promoting proliferation, survival, and migration of tumour cells via activation of signaling pathways 23‐25 …”

Neutrophil‐lymphocyte ratio at diagnosis is an independent prognostic factor in patients with nodular sclerosis Hodgkin lymphoma: results of a large multicenter study involving 990 patients

“…In HL, low ALC,1 high AMC,2 and low lymphocyte to monocyte ratios2, 7 are associated with a poor prognosis. However until now, only a few studies have analyzed the prognostic significance of ANC and NLR in patients with HL.…”

“…Several investigators have considered the absolute lymphocyte count (ALC)1 as an important biomarker of tumor infiltrating lymphocytes, reflecting host immunity status, while absolute monocyte count (AMC)2 serves as a surrogate biomarker of tumor‐associated macrophages within the tumor microenvironment, and the absolute neutrophil count (ANC)3 as a measure of the systemic inflammatory response to malignancy. Inflammation is regarded as a critical component of tumor progression, and it is evident that the tumor microenvironment, is largely coordinated by inflammatory cells, which play a central role in the neoplastic process, promoting, proliferation, survival, and migration of tumor cell via activation of signaling pathways 4, 5, 6.…”

“…Inflammation is regarded as a critical component of tumor progression, and it is evident that the tumor microenvironment, is largely coordinated by inflammatory cells, which play a central role in the neoplastic process, promoting, proliferation, survival, and migration of tumor cell via activation of signaling pathways 4, 5, 6. Both AMC and ALC have been suggested as significant prognostic factors in Hodgkin lymphoma (HL),1, 7 while the ANC and the neutrophil lymphocyte ratio (NLR) at diagnosis are both prognostic factors for survival in solid tumors8 and recently have also been shown to have prognostic impact diffuse large B‐cell lymphoma (DLBCL) 3, 9. In contrast, there is only sparse data on their role as prognostic factors in patients with HL 10.…”