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Swedish lung cancer radiation study group: the prognostic value of anaemia, thrombocytosis and leukocytosis at time of diagnosis in patients with non-small cell lung cancer

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Abstract

There is a need to improve the prognostic and predictive indicators in non-small cell lung cancer (NSCLC). At present, the main focus is on genetic predictive markers while the prognostic value of the standard blood variables related to haematopoiesis has been subjected to relatively limited attention. To study the prognostic potential of haemoglobin (Hgb), platelet (Plt) and white blood cell (WBC) levels at time of diagnosis in NSCLC patients, 835 NSCLC patients, stage I-IV, who received radiotherapy with curative intention (>50 Gy), were included in the study. WBC, Plt, Hgb, gender, age at diagnosis, stage, surgery and first-line chemotherapy were studied in relation to overall survival. For patients with Hgb < 110 g/L and Hgb ≥ 110 g/L), the median survival was 11.2 and 14.5 months, respectively (p = 0.0032). For WBC > 9.0 × 109/L and < 9.0 × 109/L, the median survival was 11.6 and 15.4 months, respectively (p < 0.0001). For Plt > 350 × 109/L and <350 × 109/L, the median survival was 11.2 and 14.9 months, respectively (p < 0.0001). The median survival in patients with pathological results in all three markers was half of that in patients with normal levels of all three markers (8.0 and 16.0 months, respectively (p < 0.0001). The level of the three studied haematological biomarkers corresponds significantly to outcome in NSCLC. These results indicate that standard haematological variables may be used as guidance for the clinician in the decision-making regarding treatment intensity and patient information.

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Acknowledgments

The authors would like to thank Stiftelsen Gävle Cancerfond and Professor John Naeslunds stipendiefond for generously providing funds for this project. Also, the authors would like to thank Ola Brodin, Peter Ericsson, Claes Mercke, Enyat Mavadati, Andrzej Piwowar, Ingemar Sandin, Daniel Brattström, Shirin Mavadati and Mats Fagerlind who have helped with the gathering of patients and their medical charts as well as with the building of databases and the input of data into it.

Conflict of interest

The authors declare no conflict of interest.

Author information

Authors and Affiliations

  1. Section of Oncology, Department of Radiology, Oncology and Radiation Sciences, Uppsala University, 751 85, Uppsala, Sweden

    Georg Holgersson, Simon Ekman, Margareta Holgersson, Charlotte Mörth & Michael Bergqvist

  2. Department of Medical Sciences, Respiratory Medicine, Uppsala University, 751 85, Uppsala, Sweden

    Martin Sandelin, Kristina Lamberg Lundström & Christer Janson

  3. Department of Oncology, Gävle Hospital, 801 87, Gävle, Sweden

    Even Hoye & Stefan Bergström

  4. Department of Oncology, Umeå University Hospital, 901 87, Umeå, Sweden

    Roger Henriksson

  5. Department of Oncology, Sahlgrenska University Hospital, 413 45, Göteborg, Sweden

    Jan Nyman

  6. Karolinska University Hospital, 171 76, Stockholm, Sweden

    Signe Friesland

  7. Department of Oncology, Skåne University Hospital, 205 02, Malmö, Sweden

    Martin Helsing & Elisabet Birath

  8. Department of General Oncology, Linköping University Hospital, SE-581 85, Linköping, Sweden

    Thomas Blystad

  9. Department of Oncology, Lund University Hospital, 221 85, Lund, Sweden

    Sven-Börje Ewers

  10. Department of Oncology, Central Hospital, 651 82, Karlstad, Sweden

    Britta Löden

Authors
  1. Georg Holgersson
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  2. Martin Sandelin
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  10. Margareta Holgersson
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  16. Sven-Börje Ewers
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  18. Michael Bergqvist
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Corresponding author

Correspondence to Martin Sandelin.

Additional information

Georg Holgersson and Martin Sandelin contributed equally to this work.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Online resource 1: Patient characteristics, treatment, relapse and cause of death (PDF 83 kb)

12032_2012_247_MOESM2_ESM.pdf

Online Resource 2: Estimated median survival and 5-year survival rate for patients with different lab risk factors (PDF 55 kb)

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Holgersson, G., Sandelin, M., Hoye, E. et al. Swedish lung cancer radiation study group: the prognostic value of anaemia, thrombocytosis and leukocytosis at time of diagnosis in patients with non-small cell lung cancer. Med Oncol 29, 3176–3182 (2012). https://doi.org/10.1007/s12032-012-0247-3

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  • DOI: https://doi.org/10.1007/s12032-012-0247-3

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