Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 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

Jian L Campian  1 , Xiaobu Ye, Malcolm Brock, Stuart A Grossman
Affiliations

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.

PubMed Disclaimer

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.
See this image and copyright information in PMC

References

    1. Lissoni P, Brivio F, Fumagalli L, Messina G, Ghezzi V, Frontini L, Giani L, Vaghi M, Ardizzoia A, Gardani GS. Efficacy of cancer chemotherapy in relation to the pretreatment number of lymphocytes in patients with metastatic solid tumors. Int J Biol Markers. 2004;19:135–140. - PubMed
    1. Ray-Coquard I, Cropet C, Van Glabbeke M, Sebban C, Le Cesne A, Judson I, Tredan O, Verweij J, Biron P, Labidi I, Guastalla JP, Bachelot T, Perol D, Chabaud S, Hogendoorn PC, Cassier P, Dufresne A, Blay JY. Lymphopenia as a prognostic factor for overall survival in advanced carcinomas, sarcomas, and lymphomas. Cancer Res. 2009;69:5383–5391. - PMC - PubMed
    1. Hiraoka K, Miyamoto M, Cho Y, Suzuoki M, Oshikiri T, Nakakubo Y, Itoh T, Ohbuchi T, Kondo S, Katoh H. Concurrent infiltration by CD8+ T cells and CD4+ T cells is a favourable prognostic factor in non-small-cell lung carcinoma. Br J Cancer. 2006;94:275–280. - PMC - PubMed
    1. Lohr J, Ratliff T, Huppertz A, Ge Y, Dictus C, Ahmadi R, Grau S, Hiraoka N, Eckstein V, Ecker RC, Korff T, von Deimling A, Unterberg A, Beckhove P, Herold-Mende C. Effector T-cell in-filtration positively impacts survival of glioblastoma patients and is impaired by tumor-derived TGF-beta. Clin Cancer Res. 2011;17:4296–4308. - PubMed
    1. Swann JB, Smyth MJ. Immune surveillance of tumors. J Clin Invest. 2007;117:1137–1146. - PMC - PubMed