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Eur J Cancer. 2016 Apr;57:127-35. doi: 10.1016/j.ejca.2016.01.016. Epub 2016 Feb 23.

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

Author information

1
Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, South Korea.
2
Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, South Korea. Electronic address: hemakim@yuhs.ac.

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 × 10(6)/L (range, 210-3610), with lymphopenia (≤ 875 × 10(6)/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.

KEYWORDS:

Lymphopenia; Primary central nervous system lymphoma; Prognosis

PMID:
26918738
DOI:
10.1016/j.ejca.2016.01.016
[Indexed for MEDLINE]

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