BACKGROUND: Cancer patients with CD4 lymphopenia have an increased risk of severe toxicity after administration of cytotoxic chemotherapy. The impact of CD4 lymphopenia on long term overall survival (OS) of cancer patients was explored in this work. PATIENTS AND METHODS: The first prospective series (test series) included 219 patients with solid tumours, lymphomas or myelomas receiving chemotherapy within an oncology department in 1999 and 2000. A phenotypic analysis of lymphocyte subsets by flow cytometry was performed before chemotherapy on day 1. The prognostic value of total, CD4, CD8 and CD56 lymphocyte count for OS was tested in a multivariate analysis. The prognostic value of low CD4 counts was then tested in a validation series of 269 patients with metastatic solid tumours in second line treatment included in a prospective observational study in the Centre Leon Berard. RESULTS: In the test series, all patients with metastatic cancers and CD4 lymphopenia ≤ 200/μL (12% of metastatic patients) died within 18 months with a median OS of 5.9 months. CD4 count was an independent prognostic factor for OS and PFS in multivariate analysis. In the validation series, 83 (30%) of patients had CD4 count ≤ 200/μL: their median overall survival was 3.9 months with an 18-month survival rate of 6%. CD4 count was also an independent prognostic factor for overall survival in this series. CONCLUSIONS: CD4 lymphopenia <200/μL is frequent in advanced cancer patients and associated with a very short life expectancy. These patients should be proposed for specific treatment and research approaches.
BACKGROUND:Cancerpatients with CD4lymphopenia have an increased risk of severe toxicity after administration of cytotoxic chemotherapy. The impact of CD4lymphopenia on long term overall survival (OS) of cancerpatients was explored in this work. PATIENTS AND METHODS: The first prospective series (test series) included 219 patients with solid tumours, lymphomas or myelomas receiving chemotherapy within an oncology department in 1999 and 2000. A phenotypic analysis of lymphocyte subsets by flow cytometry was performed before chemotherapy on day 1. The prognostic value of total, CD4, CD8 and CD56 lymphocyte count for OS was tested in a multivariate analysis. The prognostic value of low CD4 counts was then tested in a validation series of 269 patients with metastatic solid tumours in second line treatment included in a prospective observational study in the Centre Leon Berard. RESULTS: In the test series, all patients with metastatic cancers and CD4lymphopenia ≤ 200/μL (12% of metastatic patients) died within 18 months with a median OS of 5.9 months. CD4 count was an independent prognostic factor for OS and PFS in multivariate analysis. In the validation series, 83 (30%) of patients had CD4 count ≤ 200/μL: their median overall survival was 3.9 months with an 18-month survival rate of 6%. CD4 count was also an independent prognostic factor for overall survival in this series. CONCLUSIONS:CD4lymphopenia <200/μL is frequent in advanced cancerpatients and associated with a very short life expectancy. These patients should be proposed for specific treatment and research approaches.
Authors: John K Wiencke; Paige M Bracci; George Hsuang; Shichun Zheng; Helen Hansen; Margaret R Wrensch; Terri Rice; Melissa Eliot; Karl T Kelsey Journal: Epigenetics Date: 2014-10 Impact factor: 4.528
Authors: B Rovati; S Mariucci; S Delfanti; D Grasso; C Tinelli; C Torre; M De Amici; P Pedrazzoli Journal: Cell Oncol (Dordr) Date: 2016-01-14 Impact factor: 6.730
Authors: Mi Zhou; Paige M Bracci; Lucie S McCoy; George Hsuang; Joseph L Wiemels; Terri Rice; Shichun Zheng; Karl T Kelsey; Margaret R Wrensch; John K Wiencke Journal: Int J Cancer Date: 2015-02-02 Impact factor: 7.316
Authors: Sang Won Lee; Donghoon Choi; MinKyu Heo; Eui-Cheol Shin; Su-Hyung Park; So Jeong Kim; Yeon-Kyung Oh; Byung Ha Lee; Se Hwan Yang; Young Chul Sung; Howard Lee Journal: Clin Transl Sci Date: 2020-05-20 Impact factor: 4.689