Medical Oncology

, Volume 29, Issue 5, pp 3176–3182 | Cite as

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

  • Georg Holgersson
  • Martin Sandelin
  • Even Hoye
  • Stefan Bergström
  • Roger Henriksson
  • Simon Ekman
  • Jan Nyman
  • Martin Helsing
  • Signe Friesland
  • Margareta Holgersson
  • Kristina Lamberg Lundström
  • Christer Janson
  • Elisabet Birath
  • Charlotte Mörth
  • Thomas Blystad
  • Sven-Börje Ewers
  • Britta Löden
  • Michael Bergqvist
Original Paper


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.


Non-small cell lung cancer Prognosis Biomarker Anaemia Thrombocytosis Leukocytosis 



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.

Supplementary material

12032_2012_247_MOESM1_ESM.pdf (83 kb)
Online resource 1: Patient characteristics, treatment, relapse and cause of death (PDF 83 kb)
12032_2012_247_MOESM2_ESM.pdf (56 kb)
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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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Georg Holgersson
    • 1
  • Martin Sandelin
    • 2
  • Even Hoye
    • 3
  • Stefan Bergström
    • 3
  • Roger Henriksson
    • 4
  • Simon Ekman
    • 1
  • Jan Nyman
    • 5
  • Martin Helsing
    • 7
  • Signe Friesland
    • 6
  • Margareta Holgersson
    • 1
  • Kristina Lamberg Lundström
    • 2
  • Christer Janson
    • 2
  • Elisabet Birath
    • 7
  • Charlotte Mörth
    • 1
  • Thomas Blystad
    • 8
  • Sven-Börje Ewers
    • 9
  • Britta Löden
    • 10
  • Michael Bergqvist
    • 1
  1. 1.Section of Oncology, Department of Radiology, Oncology and Radiation SciencesUppsala UniversityUppsalaSweden
  2. 2.Department of Medical Sciences, Respiratory MedicineUppsala UniversityUppsalaSweden
  3. 3.Department of OncologyGävle HospitalGävleSweden
  4. 4.Department of OncologyUmeå University HospitalUmeåSweden
  5. 5.Department of OncologySahlgrenska University HospitalGöteborgSweden
  6. 6.Karolinska University HospitalStockholmSweden
  7. 7.Department of OncologySkåne University HospitalMalmöSweden
  8. 8.Department of General OncologyLinköping University HospitalLinköpingSweden
  9. 9.Department of OncologyLund University HospitalLundSweden
  10. 10.Department of OncologyCentral HospitalKarlstadSweden

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