Predictive value of peripheral blood lymphocyte count in breast cancer patients treated with primary chemotherapy

• Published in: Breast (Edinburgh) 2012-08, Vol.21 (4), p.468-474
• Main Authors: Vicente Conesa, Maria Angeles, Garcia-Martinez, Elena, Gonzalez Billalabeitia, Enrique, Chaves Benito, Asuncion, Garcia Garcia, Teresa, Vicente Garcia, Vicente, Ayala de la Peña, Francisco
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anti-cancer immunity; Antibodies, Monoclonal, Humanized - administration & dosage; Antineoplastic Agents - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Breast cancer; Breast Neoplasms - drug therapy; Breast Neoplasms - immunology; Breast Neoplasms - mortality; Breast Neoplasms - surgery; Cyclophosphamide - administration & dosage; Doxorubicin - administration & dosage; Drug Administration Schedule; Female; Follow-Up Studies; Hematology, Oncology and Palliative Medicine; Humans; Lymphocyte; Lymphocyte Count; Lymphopenia; Mastectomy; Middle Aged; Multivariate Analysis; Neoadjuvant chemotherapy; Neoadjuvant Therapy; Neoplasm Recurrence, Local; Prognosis; Retrospective Studies; Survival Analysis; Taxoids - administration & dosage; Trastuzumab; Treatment Outcome
• ISSN: 0960-9776; 1532-3080
• DOI: 10.1016/j.breast.2011.11.002

Abstract Peripheral blood lymphocyte (PBL) count may reflect the immune status of cancer patients. We retrospectively analyzed the predictive and prognostic impact of baseline and post-chemotherapy PBL counts in a homogeneous group of 103 breast cancer patients treated with neoadjuvant chemotherapy (anthracyclines and taxanes). In univariate analysis, baseline PBL under 1500 × 106 /L ( p  = 0.013; hazard ratio [HR]: 2.80, 95%CI 1.24–6.61), and PBL decrease >200 × 106 /L after the first cycle of chemotherapy ( p  = 0.047; HR: 2.82, 95%CI 1.01–7.86) were significantly related to disease free survival. In multivariate analysis, both baseline PBL count less than 1500 × 106 /L ( p  = 0.034; HR: 3.32, 95%CI 1.09–10.02) and PBL decrease >200 × 106 /L after first cycle ( p  = 0.032; HR: 3.25, 95%CI 1.10–9.56) showed independent prognostic value for worse disease free survival. No effect was observed for overall survival. Our data support the relevance of pre- and post-chemotherapy PBL for breast cancer recurrence after neoadjuvant chemotherapy.