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. 2013 Mar;31(3):183-8.
doi: 10.3109/07357907.2013.767342. Epub 2013 Feb 22.

Treatment-related lymphopenia in patients with stage III non-small-cell lung cancer

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Treatment-related lymphopenia in patients with stage III non-small-cell lung cancer

Jian L Campian et al. Cancer Invest. 2013 Mar.

Abstract

Background: This study sought to estimate the severity, etiology, and clinical importance of treatment-related lymphopenia in patients with stage III non-small-cell lung cancer.

Methods: Serial lymphocyte counts and survival were analyzed retrospectively in 47 patients accounting for known prognostic factors.

Results: Total lymphocyte counts (TLCs) were normal before therapy and did not change following neoadjuvant chemotherapy. Following radiation, TLC fell by 67% (median 500 cells/mm(3), p <.00001). Multivariate analysis revealed an association between severe TLC and survival (HR 1.70, 95% CI: 0.8-3.6).

Conclusions: Rapid and severe lymphopenia occurred in 50% of patients following radiation which was associated with reduced survival.

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Conflict of interest statement

DECLARATION OF INTEREST

The authors report no conflicts of interest.

Figures

Figure 1
Figure 1
Median total lymphocyte counts dropped significantly with the addition of radiation. Twenty patients (solid red line) received two cycles of neoadjuvant chemotherapy followed by concurrent chemoradiation. Twenty-seven patients (broken blue line) received only concurrent chemoradiation. While neoadjuvant chemotherapy did not reduce TLCs, 2 months after beginning combined radiation/chemotherapy (2nd gray arrow), TLCs fell by 68%. Gray arrows depict the start of radiation exposure in both treatments.
Figure 2
Figure 2
Kaplan–Meier survival curves for patients with total lymphocyte counts above (solid blue line) and below (broken red line) 500 cells/mm3.

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