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Absolute lymphocyte count decreases with disease progression and is a potential prognostic marker for metastatic breast cancer

  • Preclinical study
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Abstract

Purpose

Peripheral blood parameters such as the neutrophil-to-lymphocyte ratio (NLR) are prognostic markers for breast cancer patients. For instance, patients with a high NLR have a poor prognosis. Meanwhile, high absolute lymphocyte count (ALC) is reportedly a predictive factor for some chemotherapies. However, the underlying mechanisms behind how these markers relate to patient outcomes and how these markers change during the clinical course of patients with metastatic breast cancer (MBC) remains unknown.

Methods

We retrospectively investigated 156 patients who were treated for MBC and eventually transitioned to best supportive care (BSC) at our hospital between January 2017 and December 2021. Changes in peripheral blood parameters during MBC treatments and their association with patient outcomes were examined.

Results

From the time of MBC diagnosis (baseline) through to the transition to BSC, ALC became significantly lower, while the NLR and platelet-to-lymphocyte ratio (PLR) became significantly higher (p < 0.001 for all). This association was independent of hormone receptor status. Cox proportional hazard modeling found patients with hormone receptor-negative and a lower baseline ALC had a significantly shorter overall survival (p = 0.030 and p = 0.019, respectively).

Conclusion

We observed that peripheral blood markers gradually changed with MBC disease progression. Our data suggest that baseline ALC may be a potential prognostic marker after recurrence.

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Acknowledgements

The authors sincerely appreciate Clear Science Pty Ltd for language editing.

Funding

This study did not receive any funding.

Author information

Authors and Affiliations

  1. Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan

    Hikari Jimbo, Yoshiya Horimoto, Yumiko Ishizuka, Noriko Nogami, Ayana Shikanai, Mitsue Saito & Junichiro Watanabe

  2. Department of Palliative Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan

    Noriko Nogami

Authors
  1. Hikari Jimbo
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  2. Yoshiya Horimoto
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  3. Yumiko Ishizuka
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  4. Noriko Nogami
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  5. Ayana Shikanai
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  6. Mitsue Saito
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  7. Junichiro Watanabe
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Contributions

HJ, YH, and YI designed this study. HJ, YH, YI, AS, and NN collected clinical data. HJ and YH conducted data analysis and statistics. HJ and YH drafted the original manuscript and MS and JW substantively revised it. All authors have read and approved the manuscript.

Corresponding author

Correspondence to Yoshiya Horimoto.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the ethics committee of Juntendo University Hospital (H19-0289) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Supplementary Information

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10549_2022_6748_MOESM1_ESM.tif

Supplementary file1 Supplementary Figure 1. Changes in peripheral blood parameters in patients with bone marrow carcinomatosis (n=15). Comparisons of ALC, NLR, and PLR between MBC diagnosis and BSC transition in patients who developed bone marrow carcinomatosis (TIF 164 KB)

10549_2022_6748_MOESM2_ESM.tif

Supplementary file2 Supplementary Figure 2. Changes in peripheral blood markers in representative cases. Changes in ALC, NLR, and PLR during the clinical course of Case 1 (A) and Case 2 (B). Vertical blue lines indicate the time systemic treatment was changed due to disease progression, dotted lines indicate the time of BSC transition. Yellow and green horizontal lines on the x-axis indicate endocrine therapy and chemotherapy, respectively (TIF 262 KB)

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Jimbo, H., Horimoto, Y., Ishizuka, Y. et al. Absolute lymphocyte count decreases with disease progression and is a potential prognostic marker for metastatic breast cancer. Breast Cancer Res Treat 196, 291–298 (2022). https://doi.org/10.1007/s10549-022-06748-4

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  • DOI: https://doi.org/10.1007/s10549-022-06748-4

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