title: Pretreatment lymphopenia is an easily detectable predictive and prognostic marker in patients with metastatic esophagus squamous cell carcinoma receiving first-line chemotherapy.
abstract: To explore the influence of pretreatment lymphopenia on the toxicity and efficacy of first-line chemotherapy in patients with metastatic esophagus squamous cell carcinoma (ESCC). In total, 215 patients were included in this retrospective study. Correlations between pretreatment lymphopenia (lymphocyte count <1 × 10(9) /L) and the occurrence of toxicity and the efficacy of first-line palliative chemotherapy were investigated. Pretreatment lymphopenia was found in 19.1% of the patients. The overall response rate (ORR) was 35.5% (65 of 183 patients). Patients with pretreatment lymphopenia had a lower ORR to chemotherapy compared with those without lymphopenia (22.2% vs. 38.8%, respectively; P = 0.045). Furthermore, the patients with pretreatment lymphopenia have higher grade 3-4 hematological toxicity than that of patients without pretreatment lymphopenia (19 of 41 patients, 46.3% vs. 54 of 174 patients, 31.0%; P = 0.048). Pretreatment lymphopenia was not correlated with grade 3-4 nonhematological toxicity. Multivariate analysis showed that pretreatment lymphopenia is an independent prognostic factor. Patients with pretreatment lymphopenia had a significantly shorter overall survival time than those without lymphopenia (8.2 months vs. 12.7 months; P = 0.020). This study shows that pretreatment lymphopenia is a good prognostic factor as well as a predictive factor for tumor response and chemotherapy-related hematological toxicity in metastatic ESCC.
authors.affiliation: Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of GI Oncology, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, 100142, China.
authors.forename: Furong
authors.initials: F
authors.lastname: Kou
authors.affiliation: Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of GI Oncology, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, 100142, China.
authors.forename: Zhihao
authors.initials: Z
authors.lastname: Lu
authors.affiliation: Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of GI Oncology, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, 100142, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Li
authors.affiliation: Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of GI Oncology, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, 100142, China.
authors.forename: Xiaotian
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of GI Oncology, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, 100142, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Lu
authors.affiliation: Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of GI Oncology, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, 100142, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of GI Oncology, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, 100142, China.
authors.forename: Xicheng
authors.initials: X
authors.lastname: Wang
authors.affiliation: Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of GI Oncology, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, 100142, China.
authors.forename: Jifang
authors.initials: J
authors.lastname: Gong
authors.affiliation: Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of GI Oncology, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, 100142, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Gao
authors.affiliation: Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of GI Oncology, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, 100142, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Li
authors.affiliation: Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of GI Oncology, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, 100142, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of GI Oncology, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, 100142, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Shen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000556:secondary*; D004938:Esophageal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000556:secondary*; D000077277:Esophageal Squamous Cell Carcinoma; D005260:Female; D006402:Hematologic Diseases / Q000139:chemically induced; D006801:Humans; D053208:Kaplan-Meier Estimate; D018655:Lymphocyte Count; D008231:Lymphopenia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Chemotherapy; efficacy; esophageal squamous cell carcinoma; lymphopenia; prognosis; toxicity
references.citation: Cancer Chemother Pharmacol. 2011 Nov;68(5):1305-13
references.pmid: 21448592
references.citation: Clin Cancer Res. 2002 Aug;8(8):2553-62
references.pmid: 12171883
references.citation: Nat Immunol. 2002 Nov;3(11):991-8
references.pmid: 12407406
references.citation: J Clin Oncol. 2006 Dec 1;24(34):5373-80
references.pmid: 17135638
references.citation: Lancet Oncol. 2013 Jun;14(7):627-37
references.pmid: 23623280
references.citation: Brain Behav Immun. 2007 May;21(4):503-13
references.pmid: 17293081
references.citation: In Vivo. 2005 Nov-Dec;19(6):1077-80
references.pmid: 16277025
references.citation: Cancer. 2004 Dec 1;101(11):2675-80
references.pmid: 15503313
references.citation: Clin Cancer Res. 2001 Mar;7(3 Suppl):947s-957s
references.pmid: 11300496
references.citation: Jpn J Clin Oncol. 2001 Sep;31(9):419-23
references.pmid: 11689594
references.citation: Br J Cancer. 2001 Sep 14;85(6):816-22
references.pmid: 11556830
references.citation: J Geriatr Oncol. 2014 Apr;5(2):156-63
references.pmid: 24495699
references.citation: Brain Behav Immun. 2010 Mar;24(3):376-86
references.pmid: 19254757
references.citation: Cancer Med. 2016 May;5(5):778-86
references.pmid: 26814381
references.citation: Vet J. 2015 Aug;205(2):175-9
references.pmid: 25956342
references.citation: Clin Cancer Res. 2011 Aug 15;17(16):5473-80
references.pmid: 21737504
references.citation: Annu Rev Immunol. 1999;17:221-53
references.pmid: 10358758
references.citation: Br J Cancer. 2003 Jan 27;88(2):181-6
references.pmid: 12610500
references.citation: Cancer Invest. 2013 Mar;31(3):183-8
references.pmid: 23432821
references.citation: Science. 2011 Mar 25;331(6024):1565-70
references.pmid: 21436444
references.citation: Annu Rev Med. 1996;47:481-91
references.pmid: 8712798
references.citation: Int J Biol Markers. 2004 Apr-Jun;19(2):135-40
references.pmid: 15255546
references.citation: J Immunol. 2014 Jul 15;193(2):627-34
references.pmid: 24928999
references.citation: Hepatogastroenterology. 2008 Sep-Oct;55(86-87):1631-5
references.pmid: 19102357
references.citation: Medicine (Baltimore). 2014 Dec;93(27):e257
references.pmid: 25501097
references.citation: Cancer Chemother Pharmacol. 2014 Dec;74(6):1207-15
references.pmid: 25267597
references.citation: Head Neck. 2014 Dec;36(12):1747-53
references.pmid: 24174270
references.citation: CA Cancer J Clin. 2011 Mar-Apr;61(2):69-90
references.pmid: 21296855
references.citation: Am J Hematol. 2003 Aug;73(4):263-6
references.pmid: 12879430
references.citation: Head Neck. 2012 Dec;34(12):1769-76
references.pmid: 22318781
references.citation: Oncology. 1991;48(2):125-7
references.pmid: 1997935
references.citation: Eur J Cancer. 1997 Jul;33(8):1216-20
references.pmid: 9301445
references.citation: J Clin Oncol. 2003 Nov 15;21(22):4235-8
references.pmid: 14615453
references.citation: Lung Cancer. 2012 Feb;75(2):223-7
references.pmid: 21764477
references.citation: Onco Targets Ther. 2014 Oct 13;7:1875-81
references.pmid: 25342911
references.citation: Oncoimmunology. 2012 Dec 1;1(9):1617-1619
references.pmid: 23264913
references.citation: J Immunother. 2003 Sep-Oct;26(5):394-402
references.pmid: 12973028
references.citation: Nat Rev Clin Oncol. 2011 Mar;8(3):151-60
references.pmid: 21364688
references.citation: Blood. 1998 Jul 15;92(2):405-10
references.pmid: 9657738
references.citation: Cancer Invest. 2012 Oct;30(8):571-6
references.pmid: 22812722
references.citation: Lancet Oncol. 2014 Jul;15(8):894-904
references.pmid: 24950987
references.citation: J Immunol. 1999 Feb 15;162(4):2154-61
references.pmid: 9973490