Cancer Chemotherapy and Pharmacology

, Volume 68, Issue 5, pp 1305–1313

Pre-treatment lymphopenia as a prognostic biomarker in colorectal cancer patients receiving chemotherapy

  • N. Cézé
  • G. Thibault
  • G. Goujon
  • J. Viguier
  • H. Watier
  • E. Dorval
  • T. Lecomte
Original Article

DOI: 10.1007/s00280-011-1610-3

Cite this article as:
Cézé, N., Thibault, G., Goujon, G. et al. Cancer Chemother Pharmacol (2011) 68: 1305. doi:10.1007/s00280-011-1610-3
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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.

Patients and 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.

Keywords

Colorectal cancer Chemotherapy Lymphopenia Predictive factor 

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • N. Cézé
    • 1
    • 2
  • G. Thibault
    • 1
    • 3
    • 4
  • G. Goujon
    • 1
    • 2
  • J. Viguier
    • 2
  • H. Watier
    • 1
    • 3
    • 4
  • E. Dorval
    • 1
    • 2
  • T. Lecomte
    • 1
    • 2
    • 4
    • 5
  1. 1.François-Rabelais UniversityToursFrance
  2. 2.Department of Hepato-Gastroenterology and Digestive OncologyUniversity Hospital of ToursToursFrance
  3. 3.Immunology LaboratoryUniversity Hospital of ToursToursFrance
  4. 4.UMR 6239 Génétique, Immunothérapie Chimie et CancerCNRSParisFrance
  5. 5.Service d’Hépatogastroentérologie, Hôpital TrousseauCHRU de ToursToursFrance

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