Lymphopenia at diagnosis is highly prevalent in myelodysplastic syndromes and has an independent negative prognostic value in IPSS-R-low-risk patients.

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License: CC BY 4.0
Serval ID
serval:BIB_E6110C1C36FA
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Lymphopenia at diagnosis is highly prevalent in myelodysplastic syndromes and has an independent negative prognostic value in IPSS-R-low-risk patients.
Journal
Blood cancer journal
Author(s)
Silzle T., Blum S., Schuler E., Kaivers J., Rudelius M., Hildebrandt B., Gattermann N., Haas R., Germing U.
ISSN
2044-5385 (Electronic)
ISSN-L
2044-5385
Publication state
Published
Issued date
09/08/2019
Peer-reviewed
Oui
Volume
9
Number
8
Pages
63
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Lymphopenia is associated with an increased mortality in several medical conditions. Its prognostic impact in myelodysplastic syndromes (MDS) is less well studied. Hence, we analyzed 1023 patients from the Düsseldorf MDS-registry with regard to the absolute lymphocyte count (ALC) at diagnosis. An ALC below the median of the population (1.2 × 10 <sup>9</sup> /l) was associated with lower counts of neutrophils (median 1.35 vs. 1.92 × 10 <sup>9</sup> /l, p < 0.001) and platelets (median 100 vs. 138 × 10 <sup>9</sup> /l, p < 0.001) and with a significant lower overall survival in univariate analysis (whole cohort: median 36 vs. 46 months, p = 0.016; 721 patients without hematopoietic stem cell transplantation or induction chemotherapy: median 36 vs. 56 months, p = 0.001). For low-risk MDS according to IPSS-R, an ALC < 1.2 × 10 <sup>9</sup> /l was of additional prognostic value in a multivariate Cox regression model together with age (< or ≥65 years) and LDH (< or ≥normal value of 240 U/l; HR 1.46, 95% CI: 1.03-2.08, p = 0.033). These data support the hypothesis of subtle but clinical relevant changes of the adaptive immune system in MDS. Further studies are necessary to identify the ALC cut-off best suitable for prognostication and the mechanisms responsible for the impairment of lymphoid homeostasis in MDS.
Keywords
Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Lymphocyte Count, Lymphopenia/blood, Lymphopenia/pathology, Male, Middle Aged, Myelodysplastic Syndromes/blood, Myelodysplastic Syndromes/pathology, Nomograms, Prognosis, Retrospective Studies, Risk Factors, Survival Rate, Young Adult
Pubmed
Web of science
Open Access
Yes
Create date
16/08/2019 20:00
Last modification date
03/05/2020 6:01
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