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

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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.

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Conflict of interest

The authors indicated no potential conflict of interest.

Author information

Authors and Affiliations

  1. François-Rabelais University, Tours, France

    N. Cézé, G. Thibault, G. Goujon, H. Watier, E. Dorval & T. Lecomte

  2. Department of Hepato-Gastroenterology and Digestive Oncology, University Hospital of Tours, Tours, France

    N. Cézé, G. Goujon, J. Viguier, E. Dorval & T. Lecomte

  3. Immunology Laboratory, University Hospital of Tours, Tours, France

    G. Thibault & H. Watier

  4. UMR 6239 Génétique, Immunothérapie Chimie et Cancer, CNRS, Paris, France

    G. Thibault, H. Watier & T. Lecomte

  5. Service d’Hépatogastroentérologie, Hôpital Trousseau, CHRU de Tours, Tours Cedex 09, 37044, Tours, France

    T. Lecomte

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  1. N. Cézé
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  2. G. Thibault
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Correspondence to T. Lecomte.

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Cézé, N., Thibault, G., Goujon, G. et al. Pre-treatment lymphopenia as a prognostic biomarker in colorectal cancer patients receiving chemotherapy. Cancer Chemother Pharmacol 68, 1305–1313 (2011). https://doi.org/10.1007/s00280-011-1610-3

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  • DOI: https://doi.org/10.1007/s00280-011-1610-3

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