title: [Paraneoplastic Leukocytosis and Thrombocytosis as Prognostic Biomarkers in Non-small Cell Lung Cancer].
abstract: BACKGROUND
  Search for inexpensive laboratory markers have identified associations between blood counts and lung cancer outcomes. In this study, we evaluated the prognostic value of paraneoplastic leukocytosis (p-Leukocytosis) and paraneoplastic thrombocytosis (p-Thrombocytosis) in patients with non-small cell lung cancer (NSCLC). We also studied their relation to the expression of commonly detected molecular markers.
  
  
  METHODS
  We conducted a retrospective chart review on 571 consecutive NSCLC patients over a 10 year period. Blood counts were recorded at the time of cancer diagnosis. Kaplan-Meier survival curves were used to compare overall survival (OS) between patients with and without p-Leukocytosis (or) p-Thrombocytosis (p-Leuko/Thrombocytosis). Cox regression was used to determine if leukocytosis/thrombocytosis was a predictor of OS in NSCLC.
  
  
  RESULTS
  Patients with p-Leukocytosis and p-Thrombocytosis had a significantly poorer survival compared patients with normal blood counts (P<0.001). In a multivariate survival analysis, both continued to correlate even when adjusted for histology, gender, stage and chemotherapy (P<0.01, 0.03 respectively). Stage I and II NSCLC with p-Leuko/Thrombocytosis did not perform poorly compared to stage I/II NSCLC patients without paraneoplasia. Patients with the combined leukothrombocytosis syndrome did not have worse outcomes compared to those with either paraneoplastic syndrome alone.
  
  
  CONCLUSIONS
  p-Leuko/Thrombocytosis is an accessible laboratory parameter of prognostic value in NSCLC. Evidence of p-Leuko/Thrombocytosis portends poor survival. The role of various cytokines in tumor pathobiology provides a rationale for identifying cytokine factors responsible for the paraneoplasia and administering anti-cytokine therapies alongside traditional chemotherapy in an attempt to improve survival outcomes in these subset of patients.
authors.affiliation: Department of Internal Medicine, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA.
authors.forename: Prajwal
authors.initials: P
authors.lastname: Boddu
authors.affiliation: Department of Clinical Research, Advocate Illinois Masonic Hospital, Chicago, IL 60657, USA.
authors.forename: Dana
authors.initials: D
authors.lastname: Villlines
authors.affiliation: Hematology/Oncology, Advocate Creticos Cancer Center, Chicago, IL 60657, USA.
authors.forename: Mebea
authors.initials: M
authors.lastname: Aklilu
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D001772:Blood Cell Count; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D005260:Female; D006801:Humans; D007964:Leukocytosis / Q000097:blood*; D008175:Lung Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013922:Thrombocytosis / Q000097:blood*
chemical_list: D014408:Biomarkers, Tumor