A new prognostic model using absolute lymphocyte count in patients with primary central nervous system lymphoma

Ji Eun Jang, Yu Ri Kim, Soo Jeong Kim, Hyunsoo Cho, Haerim Chung, Jung Yeon Lee, Hyunsung Park, Yundeok Kim, June Won Cheong, Yoo Hong Min, Jin Seok Kim

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14 Citations (Scopus)

Abstract

Purpose Primary central nervous system lymphoma (PCNSL) is an aggressive and rare extranodal non-Hodgkin lymphoma (NHL). Absolute lymphocyte count (ALC) has been suggested to have a prognostic value in several subtypes of NHL. We evaluated the prognostic significance of clinical factors, including ALC, in patients with PCNSL to develop a new prognostic model. Methods We analysed prognostic factors, including ALC, at diagnosis in 81 PCNSL patients receiving high-dose methotrexate-based therapy. Results The median ALC at diagnosis was 1210 × 106/L (range, 210–3610), with lymphopenia (≤875 × 106/L) being detected in 27 (33.3%) patients. In the multivariate analysis, Eastern Cooperative Oncology Group performance status (ECOG PS) >1 (hazard ratio [HR] 3.18, P = 0.003), age >50 years (HR 4.23, P = 0.012), and lymphopenia at diagnosis (HR 2.83, P = 0.008) remained independent prognostic factors for low overall survival (OS). Lymphopenia was also a significant prognostic factor for progression-free survival (HR 3.17, P = 0.001). By means of a new three-factor prognostic model using ECOG PS >1, age >50 years, and presence of lymphopenia, with 1 point assigned to each factor, we successfully classified the patients into three risk groups: low (0 and 1), intermediate (2), and high (3). The 5-year OS rates of the patients in the low-, intermediate-, and high-risk groups were 74.3%, 21.7%, and 12.5%, respectively (P < 0.001). Conclusions Low ALC is a useful indicator of poor prognosis in patients with PCNSL. The proposed three-factor model should be validated in large-scale studies.

Original languageEnglish
Pages (from-to)127-135
Number of pages9
JournalEuropean Journal of Cancer
Volume57
DOIs
Publication statusPublished - 2016 Apr 1

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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    Jang, J. E., Kim, Y. R., Kim, S. J., Cho, H., Chung, H., Lee, J. Y., Park, H., Kim, Y., Cheong, J. W., Min, Y. H., & Kim, J. S. (2016). A new prognostic model using absolute lymphocyte count in patients with primary central nervous system lymphoma. European Journal of Cancer, 57, 127-135. https://doi.org/10.1016/j.ejca.2016.01.016