Original Article

You have full text access to this OnlineOpen article

Absolute lymphocyte count is a novel prognostic indicator in ALL and AML

Implications for risk stratification and future studies

  1. Guillermo De Angulo MD1,
  2. Carrie Yuen MD1,
  3. Shana L. Palla MS2,
  4. Peter M. Anderson MD, PhD1,
  5. Patrick A. Zweidler-McKay MD, PhD1,†,*

Article first published online: 30 NOV 2007

DOI: 10.1002/cncr.23168

Issue

Cancer

Cancer

Volume 112, Issue 2, pages 407–415, 15 January 2008

Additional Information

How to Cite

De Angulo, G., Yuen, C., Palla, S. L., Anderson, P. M. and Zweidler-McKay, P. A. (2008), Absolute lymphocyte count is a novel prognostic indicator in ALL and AML. Cancer, 112: 407–415. doi: 10.1002/cncr.23168

Author Information

  1. 1

    Division of Pediatrics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas

  2. 2

    Department of Biostatistics & Applied Mathematics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas

  1. †

    Fax: (713) 563-5407

*Children's Cancer Hospital, The University of Texas M. D. Anderson Cancer Center, Division of Pediatrics, Unit 853, 1515 Holcombe Blvd., Houston TX 77030-4009

Publication History

  1. Issue published online: 4 JAN 2008
  2. Article first published online: 30 NOV 2007
  3. Manuscript Accepted: 10 AUG 2007
  4. Manuscript Revised: 9 AUG 2007
  5. Manuscript Received: 13 JUN 2007

SEARCH

SEARCH BY CITATION

ARTICLE TOOLS

View Full Article (HTML) Get PDF (220K)

REFERENCES

  • 1
    Pui CH,Relling MV,Downing JR. Acute lymphoblastic leukemia. N Engl J Med. 2004; 350: 1535–1548.
  • 2
    Nachman JB,Sather HN,Sensel MG, et al. Augmented post-induction therapy for children with high-risk acute lymphoblastic leukemia and a slow response to initial therapy. N Engl J Med. 1998; 338: 1663–1671.
  • 3
    Woods WG,Kobrinsky N,Buckley JD, et al. Timed-sequential induction therapy improves postremission outcome in acute myeloid leukemia: a report from the Children's Cancer Group. Blood. 1996; 87: 4979–4989.
  • 4
    Arceci RJ. Progress and controversies in the treatment of pediatric acute myelogenous leukemia. Curr Opin Hematol. 2002; 9: 353–360.
  • 5
    Smith MAD,Camitta B,Carroll AJ, et al. Uniform approach to risk classification and treatment assignment for children with acute lymphoblastic leukemia. J Clin Oncol. 1996; 14: 4–6.
  • 6
    Pui CH,Evans WE. Treatment of acute lymphoblastic leukemia. N Engl J Med. 2006; 354: 166–178.
  • 7
    Dworzak MN,Froschl G,Printz D, et al. Prognostic significance and modalities of flow cytometric minimal residual disease detection in childhood acute lymphoblastic leukemia. Blood. 2002; 99: 1952–198.
  • 8
    Coustan-Smith E,Ribeiro RC,Stow P, et al. A simplified flow cytometric assay identifies children with acute lymphoblastic leukemia who have a superior clinical outcome. Blood. 2006; 108: 97–102.
  • 9
    Grimwade D,Walker H,Oliver F, et al. The importance of diagnostic cytogenetics on outcome in AML: analysis of 1,612 patients entered into the MRC AML 10 trial. The Medical Research Council Adult and Children's Leukaemia Working Parties. Blood. 1998; 92: 2322–2333.
  • 10
    Lowdell MW,Lamb L,Hoyle C, et al. Non-MHC-restricted cytotoxic cells: their roles in the control and treatment of leukaemias. Br J Haematol. 2001; 114: 11–24.
    Direct Link:
  • 11
    Porrata LF,Litzow MR,Tefferi A, et al. Early lymphocyte recovery is a predictive factor for prolonged survival after autologous hematopoietic stem cell transplantation for acute myelogenous leukemia. Leukemia. 2002; 16: 1311–138.
  • 12
    Porrata LF,Inwards DJ,Micallef IN, et al. Early lymphocyte recovery post-autologous haematopoietic stem cell transplantation is associated with better survival in Hodgkin's disease. Br J Haematol. 2002; 117: 629–633.
    Direct Link:
  • 13
    Porrata LF,Ingle JN,Litzow MR, et al. Prolonged survival associated with early lymphocyte recovery after autologous hematopoietic stem cell transplantation for patients with metastatic breast cancer. Bone Marrow Transplant. 2001; 28: 865–871.
  • 14
    Porrata LF,Gertz MA,Inwards DJ, et al. Early lymphocyte recovery predicts superior survival after autologous hematopoietic stem cell transplantation in multiple myeloma or non-Hodgkin lymphoma. Blood. 2001; 98: 579–585.
  • 15
    Behl D,Porrata LF,Markovic SN, et al. Absolute lymphocyte count recovery after induction chemotherapy predicts superior survival in acute myelogenous leukemia. Leukemia. 2006; 20: 29–34.
  • 16
    Hudson G,Lomas C,Manley S, et al. Lymphocyte regeneration predicts improved survival in childhood acute lymphoblastic leukaemia [abstract]. Presented at: American Society of Hematology 45th Annual meeting and Exposition, December 6–9, 2003, San Diego, California; Poster Session 503-I. Blood (ASH Annual Meeting Abstracts). 2003; 102. Abstract 1391.
  • 17
    Lomas C,Hudson G,Manley S, et al. Regeneration predicts improved survival in childhood acute myeloid leukaemia [abstract]. Presented at: American Society of Hematology 45th Annual meeting and Exposition, December 6–9, 2003, San Diego, California; Poster Session 470-III. Blood (ASH Annual Meeting Abstracts). 2003; 102. Abstract 3250.
  • 18
    Thomas DA,O'Brien S,Cortes J, et al. Outcome with the hyper-CVAD regimens in lymphoblastic lymphoma. Blood. 2004; 104: 1624–1630.
  • 19
    Kantarjian H,Thomas D,O'Brien S, et al. Long-term follow-up results of hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (hyper-CVAD), a dose-intensive regimen, in adult acute lymphocytic leukemia. Cancer. 2004; 101: 2788–2801.
    Direct Link:
  • 20
    Kern W,Schleyer E,Unterhalt M, et al. High antileukemic activity of sequential high dose cytosine arabinoside and mitoxantrone in patients with refractory acute leukemias. Results of a clinical phase II study. Cancer. 1997; 79: 59–68.
    Direct Link:
  • 21
    Woods WG,Neudorf S,Gold S, et al. A comparison of allogeneic bone marrow transplantation, autologous bone marrow transplantation, and aggressive chemotherapy in children with acute myeloid leukemia in remission. Blood. 2001; 97: 56–62.
  • 22
    Kaplan EL,Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc. 1958; 53: 457–481.
  • 23
    Cox DR. Regression models and life tables. J Roy Stat Soc. 1972; 34: 187–220.
  • 24
    Razzouk BI,Estey E,Pounds S, et al. Impact of age on outcome of pediatric acute myeloid leukemia: a report from 2 institutions. Cancer. 2006; 106: 2495–2502.
    Direct Link:
  • 25
    Faderl S,Thall PF,Kantarjian HM, et al. Time to platelet recovery predicts outcome of patients with de novo acute lymphoblastic leukaemia who have achieved a complete remission. Br J Haematol. 2002; 117: 869–874.
    Direct Link:
  • 26
    Faderl S,Estrov Z. Hematopoietic recovery following induction therapy of acute leukemias: prognostic implications and a new look at the definition of remission. Leuk Lymphoma. 2004; 45: 67–71.
  • 27
    Onciu M,Estey E,Giles FJ. Circulating blasts following chemotherapy in pediatric patients: implications for complete remission definition in acute leukemia. Hematology. 2003; 8: 295–301.
  • 28
    Spruance SL,Reid JE,Grace M, et al. Hazard ratio in clinical trials. Antimicrob Agent Chemother. 2004; 48: 2787–2792.
  • 29
    Lowdell MW,Craston R,Samuel D, et al. Evidence that continued remission in patients treated for acute leukaemia is dependent upon autologous natural killer cells. Br J Haematol. 2002; 117: 821–827.
    Direct Link:
  • 30
    Ohnishi K,Yamanishi H,Naito K, et al. Reconstitution of peripheral blood lymphocyte subsets in the long-term disease-free survivors of patients with acute myeloblastic leukemia. Leukemia. 1998; 12: 52–58.
  • 31
    Wiegering VA,Eyrich M,Schlegel PG,Winkler B. Changes in the immune functions during ALL induction therapy—prospective immune monitoring in 23 children [abstract]. Blood (ASH Annual Meeting Abstracts). 2006; 108. Abstract 4519.
  • 32
    Komada Y,Zhang SL,Zhou YW, et al. Cellular immunosuppression in children with acute lymphoblastic leukemia: effect of consolidation chemotherapy. Cancer Immunol Immunother. 1992; 35: 271–276.
  • 33
    Porrata LFGD,Padley D,Bundy K,Markovic SN. Re-infused autologous graft natural killer cells correlates with absolute lymphocyte count recovery after autologous stem cell transplantation. Leuk Lymphoma. 2003; 44: 997–1000.
  • 34
    Lake RA,Robinson BW. Immunotherapy and chemotherapy—a practical partnership. Nat Rev Cancer. 2005; 5: 397–405.
  • 35
    Nowak AK,Robinson BW,Lake RA. Gemcitabine exerts a selective effect on the humoral immune response: implications for combination chemo-immunotherapy. Cancer Res. 2002; 62: 2353–238.
  • 36
    Su YB,Sohn S,Krown SE, et al. Selective CD4+ lymphopenia in melanoma patients treated with temozolomide: a toxicity with therapeutic implications. J Clin Oncol. 2004; 22: 610–616.
  • 37
    Tsavaris N,Kosmas C,Vadiaka M, et al. Immune changes in patients with advanced breast cancer undergoing chemotherapy with taxanes. Br J Cancer. 2002; 87: 21–27.
  • 38
    Howard SC,Ribeiro RC,Pui CH. Strategies to improve outcomes of children with cancer in low-income countries. Eur J Cancer. 2005; 41: 1584–157.
  • 39
    Eden T,Pui CH,Schrappe M, et al. All children have a right to full access to treatment for cancer. Lancet. 2004; 364: 1121–112.
  • 40
    Pui CH,Ribeiro RC. International collaboration on childhood leukemia. Int J Hematol. 2003; 78: 383–389.
  • 41
    De Angulo G,Hernandez M,Morales-Arias J, et al. Early lymphocyte recovery as a prognostic indicator for high-risk Ewing's sarcoma. J Pediatr Hematol Oncol. 2007; 29: 48–52.
View Full Article (HTML) Get PDF (220K)