The prognostic value of absolute lymphocytic count (ALC), has been a recent matter of debate in non-Hodgkin-lymphoma (NHL). We assessed prospectively the value of ALC at diagnosis and also after the completion of immuno-chemotherapy in 101 diffuse-large-B-cell-lymphoma (DLBCL). Analysis of prognostic factors with respect to overall survival (OS), event free survival (EFS) and progression free survival (PFS) was done by two-tailed log-rank test. The ALC cut-off value was calculated as < 0.84 x 10(9)/L at diagnosis: this was a strong negative prognostic factor for OS (p = 0.0004), EFS (p < 0.00001) and PFS (p < 0.00001) and in multivariate analysis was independent from the revised-international-prognostic-index (R-IPI). ALC after chemo-immunotherapy was not of prognostic value. As R-IPI and ALC < 0.84 x 10(9)/L, were the factors better discriminating poor prognosis, a new trichotomous score (ALC/R-IPI) was built up: (1) low risk: R-IPI = very good or good and ALC < 0.84 x 10(9)/L; (2) intermediate risk: patients with at least one risk factor (R-IPI = poor or ALC < 0.84 x 10(9)/L). (3) high risk: patients with both risk factors. This new prognostic score was highly significant in univariate analysis for OS (p = 0.0002), EFS (p < 0.00001) and PFS (p < 0.00001). In multivariate analysis ALC/R-IPI was the most predictive factor for OS (OR = 2.954; p = 0.002) and EFS (OR = 2.381; p < 0.00001) and the only predictive factor for PFS (OR = 4.018; p < 0.00001). Our data, show that ALC at diagnosis has a strong prognostic relevance and is independent from the R-IPI. The new score including both values proved the most powerful predictor at multivariate analysis.

Low absolute lymphocyte count is a poor prognostic factor in diffuse-large-B-cell-lymphoma / Maria Christina, Cox; Nofroni, Italo; Ruco, Luigi; Rachele, Amodeo; Antonella, Ferrari; Giacinto La, Verde; Cardelli, Patrizia; Montefusco, Enrico; Esmeralda, Conte; Monarca, Bruno; ALOE SPIRITI, Maria Antonietta. - In: LEUKEMIA & LYMPHOMA. - ISSN 1042-8194. - STAMPA. - 49:9(2008), pp. 1745-1751. [10.1080/10428190802226425]

Low absolute lymphocyte count is a poor prognostic factor in diffuse-large-B-cell-lymphoma

NOFRONI, Italo;RUCO, Luigi;CARDELLI, Patrizia;MONTEFUSCO, Enrico;MONARCA, Bruno;ALOE SPIRITI, Maria Antonietta
2008

Abstract

The prognostic value of absolute lymphocytic count (ALC), has been a recent matter of debate in non-Hodgkin-lymphoma (NHL). We assessed prospectively the value of ALC at diagnosis and also after the completion of immuno-chemotherapy in 101 diffuse-large-B-cell-lymphoma (DLBCL). Analysis of prognostic factors with respect to overall survival (OS), event free survival (EFS) and progression free survival (PFS) was done by two-tailed log-rank test. The ALC cut-off value was calculated as < 0.84 x 10(9)/L at diagnosis: this was a strong negative prognostic factor for OS (p = 0.0004), EFS (p < 0.00001) and PFS (p < 0.00001) and in multivariate analysis was independent from the revised-international-prognostic-index (R-IPI). ALC after chemo-immunotherapy was not of prognostic value. As R-IPI and ALC < 0.84 x 10(9)/L, were the factors better discriminating poor prognosis, a new trichotomous score (ALC/R-IPI) was built up: (1) low risk: R-IPI = very good or good and ALC < 0.84 x 10(9)/L; (2) intermediate risk: patients with at least one risk factor (R-IPI = poor or ALC < 0.84 x 10(9)/L). (3) high risk: patients with both risk factors. This new prognostic score was highly significant in univariate analysis for OS (p = 0.0002), EFS (p < 0.00001) and PFS (p < 0.00001). In multivariate analysis ALC/R-IPI was the most predictive factor for OS (OR = 2.954; p = 0.002) and EFS (OR = 2.381; p < 0.00001) and the only predictive factor for PFS (OR = 4.018; p < 0.00001). Our data, show that ALC at diagnosis has a strong prognostic relevance and is independent from the R-IPI. The new score including both values proved the most powerful predictor at multivariate analysis.
2008
alc; antibody-based immunotherapy; hematopoiesis; lymphocytes; non-hodgkin lymphoma; prognostication
01 Pubblicazione su rivista::01a Articolo in rivista
Low absolute lymphocyte count is a poor prognostic factor in diffuse-large-B-cell-lymphoma / Maria Christina, Cox; Nofroni, Italo; Ruco, Luigi; Rachele, Amodeo; Antonella, Ferrari; Giacinto La, Verde; Cardelli, Patrizia; Montefusco, Enrico; Esmeralda, Conte; Monarca, Bruno; ALOE SPIRITI, Maria Antonietta. - In: LEUKEMIA & LYMPHOMA. - ISSN 1042-8194. - STAMPA. - 49:9(2008), pp. 1745-1751. [10.1080/10428190802226425]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/229247
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