RetroSearch Browse

Home - News ( United States | United Kingdom | Italy | Germany ) - Football scores

Showing content from https://pubmed.ncbi.nlm.nih.gov/23648440/ below:

The Association Between Chemoradiation-related Lymphopenia and Clinical Outcomes in Patients With Locally Advanced Pancreatic Adenocarcinoma

doi: 10.1097/COC.0b013e3182940ff9. The Association Between Chemoradiation-related Lymphopenia and Clinical Outcomes in Patients With Locally Advanced Pancreatic Adenocarcinoma Xiaobu Ye, Susannah G Ellsworth, Jessica A Smith, Amol K Narang, Tanu Garg, Jian Campian, Daniel A Laheru, Lei Zheng, Christopher L Wolfgang, Phuoc T Tran, Stuart A Grossman, Joseph M Herman

Affiliations

Affiliation

¹ The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD.

PMID: 23648440
PMCID: PMC3991773
DOI: 10.1097/COC.0b013e3182940ff9

Item in Clipboard

The Association Between Chemoradiation-related Lymphopenia and Clinical Outcomes in Patients With Locally Advanced Pancreatic Adenocarcinoma

Aaron T Wild et al. Am J Clin Oncol. 2015 Jun.

doi: 10.1097/COC.0b013e3182940ff9. Authors Aaron T Wild¹, Xiaobu Ye, Susannah G Ellsworth, Jessica A Smith, Amol K Narang, Tanu Garg, Jian Campian, Daniel A Laheru, Lei Zheng, Christopher L Wolfgang, Phuoc T Tran, Stuart A Grossman, Joseph M Herman Affiliation

¹ The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD.

PMID: 23648440
PMCID: PMC3991773
DOI: 10.1097/COC.0b013e3182940ff9

Item in Clipboard

Abstract

Objectives: Lymphopenia is a common consequence of chemoradiation therapy yet is seldom addressed clinically. This study was conducted to determine if patients with locally advanced pancreatic cancer (LAPC) treated with definitive chemoradiation develop significant lymphopenia and if this affects clinical outcomes.

Methods: A retrospective analysis of patients with LAPC treated with chemoradiation at a single institution from 1997 to 2011 was performed. Total lymphocyte counts (TLCs) were recorded at baseline and then monthly during and after chemoradiation. The correlation between treatment-induced lymphopenia, established prognostic factors, and overall survival was analyzed using univariate Cox regression analysis. Important factors identified by univariate analysis were selected as covariates to construct a multivariate proportional hazards model for survival.

Results: A total of 101 patients met eligibility criteria. TLCs were normal in 86% before chemoradiation. The mean reduction in TLC per patient was 50.6% (SD, 40.6%) 2 months after starting chemoradiation (P<0.00001), and 46% had TLC<500 cells/mm. Patients with TLC<500 cells/mm 2 months after starting chemoradiation had inferior median survival (8.7 vs. 13.3 mo, P=0.03) and PFS (4.9 vs. 9.0 mo, P=0.15). Multivariate analysis revealed TLC<500 cells/mm to be an independent predictor of inferior survival (HR=2.879, P=0.001) along with baseline serum albumin (HR=3.584, P=0.0002), BUN (HR=1.060, P=0.02), platelet count (HR=1.004, P=0.005), and radiation planning target volume (HR=1.003, P=0.0006).

Conclusions: Severe treatment-related lymphopenia occurs frequently after chemoradiation for LAPC and is an independent predictor of inferior survival.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures
FIGURE 1

Total lymphocyte counts over time.…

FIGURE 1

Total lymphocyte counts over time. Baseline corresponds to prechemoradiation, whereas months of follow-up…

FIGURE 1

Total lymphocyte counts over time. Baseline corresponds to prechemoradiation, whereas months of follow-up are measured from the chemoradiation start date.

FIGURE 2

Kaplan-Meier plot of survival stratified…

FIGURE 2

Kaplan-Meier plot of survival stratified by total lymphocyte count <500 (gray curve) versus ≥500 (black curve) cells/mm ³ 2 months after…500>

FIGURE 2

Kaplan-Meier plot of survival stratified by total lymphocyte count <500 (gray curve) versus ≥500 (black curve) cells/mm³ 2 months after starting chemoradiation.