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
Meta-Analysis
. 2023 Mar 7:14:1117447.
doi: 10.3389/fimmu.2023.1117447. eCollection 2023.

Blood cell counts can predict adverse events of immune checkpoint inhibitors: A systematic review and meta-analysis

Juyue Zhou  1 , Zhonghai Du  2 , Jie Fu  2 , Xiuxiu Yi  2
Affiliations
Meta-Analysis

Blood cell counts can predict adverse events of immune checkpoint inhibitors: A systematic review and meta-analysis

Juyue Zhou et al. Front Immunol. .

Abstract

Background: Cancer is concerning owing to its high mortality rate. Consequently, methods of prolonging the life of patients with cancer have become the primary focus of attention research. In recent years, immune checkpoint inhibitors (ICIs) have achieved good clinical efficacy as antitumor drugs; however, their severe adverse effects have made their use challenging. In order to clarify the predictors of adverse effects, scientists have conducted a series of studies. Blood counts can potentially monitor risk factors associated with the occurrence of immune-related adverse events (irAEs). Herein, a meta-analysis was performed to clarify further the guiding significance of blood counts in the clinical setting.

Methods: Studies that satisfied the inclusion criteria were obtained by searching the database. Included studies were those in which irAEs had been observed, and evidence of an association between blood counts and irAEs was reported. The included ones were evaluated for quality. In addition to sensitivity analysis and subgroup analysis, a meta-analysis was performed using the odds ratio (OR) and 95% confidence interval (CI) for each study.

Results: A total of 18 articles were included in our study. The analyses were performed separately according to different blood cell count indicators. The blood cell count metrics associated with irAEs were: absolute eosinophil count, neutrophil: lymphocyte ratio, and platelet: lymphocyte ratio.

Conclusion: Our review and meta-analysis of studies suggest that absolute eosinophil count, neutrophil: lymphocyte ratio, and platelet: lymphocyte ratio may serve as predictors of the emergence of irAEs. Given the small number of studies focusing on the relationship between patient blood cell counts and the risk of irAEs, future studies need to further explore the mechanisms of occurrence and potential associations.

Keywords: adverse effect; blood cell count; immune checkpoint inhibitor; immunotherapy; risk factor.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of study screening.
Figure 2
Figure 2
Forest plot of correlation between AEC and incidence of irAEs.
Figure 3
Figure 3
Forest plot of correlation between NLR and incidence of irAEs.
Figure 4
Figure 4
Forest plot of correlation between PLR and incidence of irAEs.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. von Itzstein MS, Khan S, Gerber DE. Investigational biomarkers for checkpoint inhibitor immune-related adverse event prediction and diagnosis. Clin Chem (2020) 66(6):779–93. doi: 10.1093/clinchem/hvaa081 - DOI - PMC - PubMed
    1. Zhang H, Dai Z, Wu W, Wang Z, Zhang N, Zhang L, et al. . Regulatory mechanisms of immune checkpoints pd-L1 and ctla-4 in cancer. J Exp Clin Cancer Res (2021) 40(1):184. doi: 10.1186/s13046-021-01987-7 - DOI - PMC - PubMed
    1. Morad G, Helmink BA, Sharma P, Wargo JA. Hallmarks of response, resistance, and toxicity to immune checkpoint blockade. Cell (2021) 184(21):5309–37. doi: 10.1016/j.cell.2021.09.020 - DOI - PMC - PubMed
    1. Tang Q, Chen Y, Li X, Long S, Shi Y, Yu Y, et al. . The role of pd-1/Pd-L1 and application of immune-checkpoint inhibitors in human cancers. Front Immunol (2022) 13:964442. doi: 10.3389/fimmu.2022.964442 - DOI - PMC - PubMed
    1. Zhang Y, Zhang Z. The history and advances in cancer immunotherapy: Understanding the characteristics of tumor-infiltrating immune cells and their therapeutic implications. Cell Mol Immunol (2020) 17(8):807–21. doi: 10.1038/s41423-020-0488-6 - DOI - PMC - PubMed

MeSH terms

Substances