Low absolute peripheral blood CD4+ T-cell count predicts poor prognosis in R-CHOP-treated patients with diffuse large B-cell lymphoma.

Abstract

The absolute peripheral blood lymphocyte count at diagnosis is known to be a strong prognostic factor in patients with diffuse large B-cell lymphoma (DLBCL) treated with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP), but it remains unclear as to which peripheral blood lymphocyte population is reflective of DLBCL prognosis. In this cohort, 355 patients with DLBCL treated with R-CHOP from 2006 to 2013 were analyzed. The low absolute CD4+ T-cell count (ACD4C) at diagnosis negatively correlated with the overall response rate and the complete response rate significantly (P<0.00001). An ACD4C<343 × 106/l had a significant negative impact on the 5-year progression-free survival and the overall survival as compared with an ACD4C⩾343 × 106/l (73.7% (95% confidence interval (CI)=66.7-79.5) versus 50.3% (95% CI=39.0-60.6), P<0.00001 and 83.3% (95% CI=77.1-88.0) versus 59.0% (95% CI=47.9-68.5), P<0.00000001, respectively). Multivariate analysis revealed that the ACD4C was an independent prognostic marker (hazard ratio=2.2 (95% CI=1.3-3.7), P<0.01). In conclusion, a low ACD4C at diagnosis served as an independent poor prognostic marker in patients with DLBCL.

• Authors: Y Kusano, M Yokoyama, Y Terui, N Nishimura, Y Mishima, K Ueda, N Tsuyama, H Yamauchi, A Takahashi, N Inoue, K Takeuchi, K Hatake
• Journal: Blood cancer journal (Blood Cancer J) Vol. 7 Issue 4 Pg. e558 (04 21 2017) ISSN: 2044-5385 [Electronic] United States
• PMID: 28430176 (Publication Type: Journal Article)

Chemical References

• Antibodies, Monoclonal, Murine-Derived
• R-CHOP protocol
• Rituximab
• Vincristine
• Doxorubicin
• Cyclophosphamide
• Prednisone

Topics

• Adult
• Aged
• Aged, 80 and over
• Antibodies, Monoclonal, Murine-Derived (administration & dosage, adverse effects)
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, adverse effects)
• CD4 Lymphocyte Count
• CD4-Positive T-Lymphocytes (drug effects, pathology)
• Cyclophosphamide (administration & dosage, adverse effects)
• Disease-Free Survival
• Doxorubicin (administration & dosage, adverse effects)
• Female
• Humans
• Lymphoma, Large B-Cell, Diffuse (blood, drug therapy, pathology)
• Male
• Middle Aged
• Prednisone (administration & dosage, adverse effects)
• Prognosis
• Rituximab
• Treatment Outcome
• Vincristine (administration & dosage, adverse effects)