Lymphocytes, Natural Killer, and Dendritic Cells I
Lymphocytes and Lymphocyte Activation
Absolute Lymphocyte Count Is Independent of the Anaplastic Lymphoma Kinase and Predicts Survival in Primary Anaplastic Large Cell Lymphoma.
Luis F. Porrata, MD1,
Thomas E. Witzig, MD1,
Thomas M. Haberman, MD1,
David J. Inwards, MD1,
Stephen M. Ansell, MD, PhD1,
Ivana N. Micallef, MD1,
Patrick B. Johnston, MD, PhD1,
Joseph Colgan, MD1,*,
William L. White, MD1,* and
Svetomir N. Markovic, MD, PhD1
1 Department of Medicine/Division of Hematology, Mayo Clinic College of Medicine, Rochester, MN, USA.
Peripheral blood absolute lymphocyte count (ALC) at diagnosisis a predictor of survival in B-cell lymphomas. The role ofALC at diagnosis on survival in T-cell lymphoma has not beenstudied. Thus, we studied the role of ALC at diagnosis on clinicaloutcome in adult patients with primary anaplastic large celllymphoma (PALCL) that were diagnosed, treated, and followedat the Mayo Clinic, Rochester. Between 1985 and 2006, 50 patientswith PALCL qualified for the study. ALC was identified to bea strong predictor for complete response (CR), area under thecurve (AUC = 0.83, p < 0.002). The median follow-up was 31.8months (range: 1–212.6 months). ALC, as a continuous variablewas a predictor for overall survival (OS) (HR = 0.143; 95%CI= 0.042–0.416; p < 0.0001) and progression-free survival(PFS) (HR = 0.150; 95%CI = 0.047–0.415; p < 0.0001).Superior OS and PFS (Figure 1) were observed with an ALC 1.0x 109/L (N = 31) versus an ALC < 1.0 x 109/L (N=19) (medianOS: not reached vs 7.5 months, OS rates at 5 years, 81% vs 36%,p < 0.0006, respectively; and median PFS: not reached vs6.3 months; PFS rates at 5 years, 77% vs 37%, p < 0.0007,respectively). Multivariate analysis demonstrated ALC to bean independent prognostic indicator for OS (HR = 0.196; 95%CI= 0.125–0.693; p < 0.002) and PFS (HR = 0.191; 95%CI= 0.053–0.559; p < 0.0008) when compared to anaplasticlymphoma kinase, international prognostic index, and cutaneousversus systemic presentation.