Absolute lymphocyte count at the time of first relapse predicts survival in patients with diffuse large B-cell lymphoma

Luis F. Porrata, Kay Ristow, Thomas Matthew Habermann, Thomas Elmer Witzig, David J. Inwards, Svetomir Nenad Markovic

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Abstract

Peripheral blood absolute lymphocyte count (ALC) is a survival prognostic factor in hematological malignancies. No reports have addressed whether ALC at the time of first relapse (ALC-R) predicts survival. Thus, we assessed the prognostic significance of ALC-R in diffuse large B-cell lymphoma (DLBCL). Patients were required to have been diagnosed with first relapsed DLBCL, have ALC-R values, and to be followed at Mayo Clinic, Rochester. From Feb 1987 until March 2006, 97 first relapsed DLBCL patients qualified for the study. The overall survival (OS) and progression-free survival (PFS) were measured from the time of first relapse. The value of ALC-R ≥ 1.0 × 10 9/L was used for the analysis. Both groups (ALC-R ≥ 1or < 1 × 10 9/ L) were balanced for the international prognostic index at relapse (IPI-R) (P = 0.3), and for autologous stem cell transplantation (P = 0.4). Superior OS and PFS were observed with an ALC-R ≥ 1.0 × 10 9/L (N = 60) versus ALC-R < 1.0 × 10 9/L (N = 37) [median OS: 28.7 months, 5 years OS rates of 39% versus median OS: 10.2 months, 5 years OS rates of 14%, P < 0.002; and median PFS: 14.8 months, 5 years PFS rates of 21% versus median PFS: 6.5 months, 5 years PFS rates of 8%, P < 0.004, respectively]. ALC-R was an independent prognostic factor for OS [RR = 0.4, P < 0.01] and PFS [RR = 0.5, P < 0.005]. ALC-R predicts survival suggesting that host immunity is an important variable predicting survival in first relapsed DLBCL. Am. J. Hematol.

Original languageEnglish (US)
Pages (from-to)93-97
Number of pages5
JournalAmerican Journal of Hematology
Volume84
Issue number2
DOIs
StatePublished - Feb 2009

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Lymphoma, Large B-Cell, Diffuse
Lymphocyte Count
Recurrence
Survival
Disease-Free Survival
Survival Rate
Stem Cell Transplantation
Hematologic Neoplasms
Immunity

ASJC Scopus subject areas

  • Hematology

Cite this

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title = "Absolute lymphocyte count at the time of first relapse predicts survival in patients with diffuse large B-cell lymphoma",
abstract = "Peripheral blood absolute lymphocyte count (ALC) is a survival prognostic factor in hematological malignancies. No reports have addressed whether ALC at the time of first relapse (ALC-R) predicts survival. Thus, we assessed the prognostic significance of ALC-R in diffuse large B-cell lymphoma (DLBCL). Patients were required to have been diagnosed with first relapsed DLBCL, have ALC-R values, and to be followed at Mayo Clinic, Rochester. From Feb 1987 until March 2006, 97 first relapsed DLBCL patients qualified for the study. The overall survival (OS) and progression-free survival (PFS) were measured from the time of first relapse. The value of ALC-R ≥ 1.0 × 10 9/L was used for the analysis. Both groups (ALC-R ≥ 1or < 1 × 10 9/ L) were balanced for the international prognostic index at relapse (IPI-R) (P = 0.3), and for autologous stem cell transplantation (P = 0.4). Superior OS and PFS were observed with an ALC-R ≥ 1.0 × 10 9/L (N = 60) versus ALC-R < 1.0 × 10 9/L (N = 37) [median OS: 28.7 months, 5 years OS rates of 39{\%} versus median OS: 10.2 months, 5 years OS rates of 14{\%}, P < 0.002; and median PFS: 14.8 months, 5 years PFS rates of 21{\%} versus median PFS: 6.5 months, 5 years PFS rates of 8{\%}, P < 0.004, respectively]. ALC-R was an independent prognostic factor for OS [RR = 0.4, P < 0.01] and PFS [RR = 0.5, P < 0.005]. ALC-R predicts survival suggesting that host immunity is an important variable predicting survival in first relapsed DLBCL. Am. J. Hematol.",
author = "Porrata, {Luis F.} and Kay Ristow and Habermann, {Thomas Matthew} and Witzig, {Thomas Elmer} and Inwards, {David J.} and Markovic, {Svetomir Nenad}",
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T1 - Absolute lymphocyte count at the time of first relapse predicts survival in patients with diffuse large B-cell lymphoma

AU - Porrata, Luis F.

AU - Ristow, Kay

AU - Habermann, Thomas Matthew

AU - Witzig, Thomas Elmer

AU - Inwards, David J.

AU - Markovic, Svetomir Nenad

PY - 2009/2

Y1 - 2009/2

N2 - Peripheral blood absolute lymphocyte count (ALC) is a survival prognostic factor in hematological malignancies. No reports have addressed whether ALC at the time of first relapse (ALC-R) predicts survival. Thus, we assessed the prognostic significance of ALC-R in diffuse large B-cell lymphoma (DLBCL). Patients were required to have been diagnosed with first relapsed DLBCL, have ALC-R values, and to be followed at Mayo Clinic, Rochester. From Feb 1987 until March 2006, 97 first relapsed DLBCL patients qualified for the study. The overall survival (OS) and progression-free survival (PFS) were measured from the time of first relapse. The value of ALC-R ≥ 1.0 × 10 9/L was used for the analysis. Both groups (ALC-R ≥ 1or < 1 × 10 9/ L) were balanced for the international prognostic index at relapse (IPI-R) (P = 0.3), and for autologous stem cell transplantation (P = 0.4). Superior OS and PFS were observed with an ALC-R ≥ 1.0 × 10 9/L (N = 60) versus ALC-R < 1.0 × 10 9/L (N = 37) [median OS: 28.7 months, 5 years OS rates of 39% versus median OS: 10.2 months, 5 years OS rates of 14%, P < 0.002; and median PFS: 14.8 months, 5 years PFS rates of 21% versus median PFS: 6.5 months, 5 years PFS rates of 8%, P < 0.004, respectively]. ALC-R was an independent prognostic factor for OS [RR = 0.4, P < 0.01] and PFS [RR = 0.5, P < 0.005]. ALC-R predicts survival suggesting that host immunity is an important variable predicting survival in first relapsed DLBCL. Am. J. Hematol.

AB - Peripheral blood absolute lymphocyte count (ALC) is a survival prognostic factor in hematological malignancies. No reports have addressed whether ALC at the time of first relapse (ALC-R) predicts survival. Thus, we assessed the prognostic significance of ALC-R in diffuse large B-cell lymphoma (DLBCL). Patients were required to have been diagnosed with first relapsed DLBCL, have ALC-R values, and to be followed at Mayo Clinic, Rochester. From Feb 1987 until March 2006, 97 first relapsed DLBCL patients qualified for the study. The overall survival (OS) and progression-free survival (PFS) were measured from the time of first relapse. The value of ALC-R ≥ 1.0 × 10 9/L was used for the analysis. Both groups (ALC-R ≥ 1or < 1 × 10 9/ L) were balanced for the international prognostic index at relapse (IPI-R) (P = 0.3), and for autologous stem cell transplantation (P = 0.4). Superior OS and PFS were observed with an ALC-R ≥ 1.0 × 10 9/L (N = 60) versus ALC-R < 1.0 × 10 9/L (N = 37) [median OS: 28.7 months, 5 years OS rates of 39% versus median OS: 10.2 months, 5 years OS rates of 14%, P < 0.002; and median PFS: 14.8 months, 5 years PFS rates of 21% versus median PFS: 6.5 months, 5 years PFS rates of 8%, P < 0.004, respectively]. ALC-R was an independent prognostic factor for OS [RR = 0.4, P < 0.01] and PFS [RR = 0.5, P < 0.005]. ALC-R predicts survival suggesting that host immunity is an important variable predicting survival in first relapsed DLBCL. Am. J. Hematol.

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