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Head Neck. 2014 Dec;36(12):1747-53. doi: 10.1002/hed.23535. Epub 2014 Apr 15.

Association between severe treatment-related lymphopenia and progression-free survival in patients with newly diagnosed squamous cell head and neck cancer.

Author information

1
Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, Maryland.

Abstract

BACKGROUND:

Severe treatment-related lymphopenia occurs commonly in many cancers and is associated with early tumor progression. Data are lacking as to whether this occurs in squamous cell head and neck cancer.

METHODS:

Serial total lymphocyte counts were retrospectively reviewed in patients with newly diagnosed squamous head and neck cancer undergoing chemoradiation and associated with treatment outcomes.

RESULTS:

The median baseline total lymphocyte count in 56 patients was 1660 cells/mm(3) , which fell by 73% to 445 cells/mm(3) 2 months after initiating chemoradiation (p < .0001). Human papillomavirus negative (HPV-) patients with a total lymphocyte count <500 cells/mm(3) at 2 months had significantly earlier disease progression than those with higher total lymphocyte counts (hazard ratio [HR], 5.75; p = .045).

CONCLUSION:

Baseline total lymphocyte counts were normal, but at 2 months approximately 60% of patients had severe treatment-related lymphopenia regardless of HPV status. Severe treatment-related lymphopenia in HPV- patients is independently associated with earlier disease progression. Prospective studies are needed to confirm these findings, which suggest that immune preservation is important in this cancer.

KEYWORDS:

chemotherapy; head and neck squamous cell carcinoma; lymphopenia; radiation; treatment-related toxicities

PMID:
24174270
PMCID:
PMC4081494
DOI:
10.1002/hed.23535
[Indexed for MEDLINE]
Free PMC Article

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