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
. 2023 Dec;23(8):4665-4672.
doi: 10.1007/s10238-023-01249-0. Epub 2023 Nov 8.

Prognostic impact of absolute peripheral blood NK cell count after four cycles of R-CHOP-like regimen treatment in patients with diffuse large B cell lymphoma

Zhongjun Huo #  1 , Fang Chen #  1 , Jiajia Zhao  2 , Ping Liu  1 , Zhi Chao  1 , Kang Liu  1 , Ji Zhou  1 , Dan Zhou  1 , Lu Zhang  1 , Haifeng Zhen  1 , Wenqun Yang  1 , Zhenqing Tan  1 , Kaibo Zhu  1 , Zimian Luo  3
Affiliations

Prognostic impact of absolute peripheral blood NK cell count after four cycles of R-CHOP-like regimen treatment in patients with diffuse large B cell lymphoma

Zhongjun Huo et al. Clin Exp Med. 2023 Dec.

Abstract

As a subtype of lymphocyte, natural killer (NK) cell is the first line of defense that shows a strong function in tumor immunotherapy response and clinical outcomes. The current study aims to investigate the prognostic influence of peripheral blood absolute NK cell count after four cycles of rituximab combined with cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) treatment (NKCC4) in diffuse large B cell lymphoma (DLBCL) patients. A total of 261 DLBCL patients treated with R-CHOP from January 2018 to September 2022 were enrolled. The low NKCC4 was observed in patients who died during the study period compared with survival individuals. A NKCC4 < 135 cells/μl had a remarkable negative influence in overall survival and progression-free survival (PFS) compared to a NKCC4 ≥ 135 cells/μl (p < 0.0001 and p < 0.0004, respectively). In addition, the OS and PFS were synergistically lower in a NKCC4 < 135 cells/μl group among DLBCL patients with GCB type or high IPI. In conclusion, this study indicates NCKK4 as a valuable marker in clinical practice and provides an insight for combination treatment of R-CHOP to improve outcomes of DLBCL patients.

Keywords: Diffuse large B cell lymphoma; Natural killer cell; R-CHOP chemotherapy; Survival.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Box plot analysis and optimal cutoff value analysis for NKCC4 in this cohort. A Box plot analysis of the NKCC4 in DLBCL patients who were dead or remained survival until the last follow-up. The absolute NKCC4 was significantly higher in survival patients than those who died during the study period (p < 0.0001). B Pearson correlation analysis demonstrated the positive correlation between NKCC4 and total lymphocyte count after four cycles of R-CHOP treatment (exclude data with large discrepancies). C ROC curve analysis identified NKCC4 as a biomarker for death after R-CHOP therapy. Area under the ROC curve analysis suggested a cutoff value of 135 cells/μl (AUC = 0.67)
Fig. 2
Fig. 2
Therapeutic outcomes of patients according NKCC4. A OS and B PFS. Both OS and PFS rates of patients in the high NKCC4 group were significantly higher than those in the low NKCC4 group (p < 0.0001 for OS and p < 0.0004 for PFS)
Fig. 3
Fig. 3
Survival according to the NKCC4 combined with prognostic factors. A OS and PFS according to the NKCC4 combined with IPI. B OS and PFS according to the NKCC4 combined with cell of origin. C OS and PFS according to the NKCC4 combined with DEL. The OS and PFS were synergistically lower in the low NKCC4 group among DLBCL patients with GCB type or high IPI
See this image and copyright information in PMC

References

    1. Smith A, Crouch S, Lax S, et al. Lymphoma incidence, survival and prevalence 2004–2014: sub-type analyses from the UK’s haematological malignancy research network. Br J Cancer. 2015;112(9):1575–84. doi: 10.1038/bjc.2015.94. - DOI - PMC - PubMed
    1. Teras LR, DeSantis CE, Cerhan JR, et al. 2016 US lymphoid malignancy statistics by world health organization subtypes. CA Cancer J Clin. 2016;66(6):443–59. doi: 10.3322/caac.21357. - DOI - PubMed
    1. Susanibar-Adaniya S, Barta SK. Update on diffuse large B cell lymphoma: a review of current data and potential applications on risk stratification and management. Am J Hematol. 2021;96(5):617–29. doi: 10.1002/ajh.26151. - DOI - PMC - PubMed
    1. Camus V, Belot A, Oberic L, et al. Outcomes of older patients with diffuse large B-cell lymphoma treated with R-CHOP: 10-year follow-up of the LNH03-6B trial. Blood Adv. 2022;6(24):6169–79. doi: 10.1182/bloodadvances.2022007609. - DOI - PMC - PubMed
    1. Vahamurto P, Pollari M, Clausen MR, et al. Low absolute lymphocyte counts in the peripheral blood predict inferior survival and improve the international prognostic index in testicular diffuse large b-cell lymphoma. Cancers (Basel) 2020;12(7):1967. doi: 10.3390/cancers12071967. - DOI - PMC - PubMed