Elevated lymphocyte count at time of acute myeloid leukemia diagnosis is associated with shorter remission.
In solid tumors, decreased absolute lymphocyte count (ALC) at diagnosis was found to be associated with poorer outcome, but there is only limited data on the impact of ALC in acute myeloid leukemia (AML). In this study we evaluated the prognostic value of ALC on outcome in 259 adult patients with AML who responded to induction therapy. Higher than normal ALC at diagnosis was associated with shorter remission (HR 4.06; p < 0.001), and decreased relapse free and overall survival (HR 3.47; p < 0.001 and HR 3.85; p < 0.001 respectively). Flow cytometry showed low frequency of natural killer (NK) cells and high frequency of CD4+ T cells (which includes the subset of T regulatory cells) in the high ALC group. Low frequency of NK cells and potentially high frequency of inhibitory T regulatory cells may result in weaker immune responses against residual leukemia and may explain the poorer outcome of the high ALC group.
a Division of Clinical Research, Fred Hutchinson Cancer Research Center , Seattle , WA , USA.|b Department of Medicine , University of Washington , Seattle , WA , USA.
Merav
M
Bar
c Public Heath Division, Fred Hutchinson Cancer Research Center , Seattle , WA , USA.
Megan
M
Othus
a Division of Clinical Research, Fred Hutchinson Cancer Research Center , Seattle , WA , USA.
Hanahlyn M
HM
Park
a Division of Clinical Research, Fred Hutchinson Cancer Research Center , Seattle , WA , USA.
Vicky
V
Sandhu
d Department of Laboratory Medicine , University of Washington , Seattle , WA , USA.
Xueyan
X
Chen
a Division of Clinical Research, Fred Hutchinson Cancer Research Center , Seattle , WA , USA.|d Department of Laboratory Medicine , University of Washington , Seattle , WA , USA.
Brent L
BL
Wood
a Division of Clinical Research, Fred Hutchinson Cancer Research Center , Seattle , WA , USA.|b Department of Medicine , University of Washington , Seattle , WA , USA.
Elihu
E
Estey
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D015415:Biomarkers; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D015470:Leukemia, Myeloid, Acute / Q000097:blood* / Q000188:drug therapy / Q000401:mortality*; D018655:Lymphocyte Count; D016131:Lymphocyte Subsets / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012074:Remission Induction; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
D015415:Biomarkers
Acute myeloid leukemia (AML); absolute lymphocyte count (ALC)