title: Pre-treatment lymphopenia as a prognostic biomarker in colorectal cancer patients receiving chemotherapy.
abstract: BACKGROUND
  Lymphopenia is a predictor of the efficacy and hematological toxicity of chemotherapy in various advanced cancers. There is little data about this relationship in colorectal cancer. In this retrospective study, the influence of pretreatment lymphopenia on hematological toxicity and the efficacy of chemotherapy was investigated in colorectal cancer patients.
  
  
  METHODS
  In total, 260 patients were included in the study. Correlations between pre-treatment lymphopenia (lymphocyte count < 1,000/μl) and the occurrence of hematological toxicity and efficacy of first-line palliative chemotherapy were investigated.
  
  
  RESULTS
  Lymphopenia was found in 49/260 (19%) patients. Ten of these patients with lymphopenia (20.4%) experienced severe hematological toxicity compared with 17 of the remaining 211 (8%) patients (P = 0.01). Lymphopenia was identified as an independent factor for hematological toxicity. Among patients who received palliative chemotherapy, the objective response rate was significantly lower in lymphopenic patients than in the other patients (12.5% vs. 40.2%; P = 0.004). Lymphopenia was strongly associated with shorter progression-free survival (median 4 vs. 7 months; P = 0.033) and shorter overall survival (median 16 vs. 24 months, P = 0.024). Multivariate analysis revealed that lymphopenia had an independent effect on survival.
  
  
  CONCLUSIONS
  Our findings show that lymphopenia is an independent predictive factor for both hematological toxicity and efficacy of chemotherapy in colorectal cancer. Pre-treatment lymphocyte count may represent a simple and new predictive biomarker of chemotherapy effects in colorectal cancer patients.
authors: François-Rabelais University, Tours, France.
authors: N
authors: N
authors: Cézé
authors: G
authors: G
authors: Thibault
authors: G
authors: G
authors: Goujon
authors: J
authors: J
authors: Viguier
authors: H
authors: H
authors: Watier
authors: E
authors: E
authors: Dorval
authors: T
authors: T
authors: Lecomte
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000378:metabolism*; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D006801:Humans; D008231:Lymphopenia / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor