Low absolute peripheral blood CD4+ T-cell count predicts poor prognosis in R-CHOP-treated patients with diffuse large...

Area of Science:

• Oncology
• Immunology
• Hematology

Background:

• The absolute peripheral blood lymphocyte count is a prognostic factor in diffuse large B-cell lymphoma (DLBCL) patients treated with R-CHOP.
• The specific lymphocyte population reflecting DLBCL prognosis remains unclear.

Purpose of the Study:

• To investigate the prognostic significance of peripheral blood lymphocyte populations in DLBCL patients treated with R-CHOP.
• To determine if absolute CD4+ T-cell count (ACD4C) is an independent prognostic marker in DLBCL.

Main Methods:

• Analysis of 355 DLBCL patients treated with R-CHOP between 2006 and 2013.
• Correlation of absolute CD4+ T-cell count (ACD4C) at diagnosis with response rates and survival outcomes.
• Multivariate analysis to assess ACD4C as an independent prognostic marker.

Main Results:

• A low ACD4C at diagnosis negatively correlated with overall response rate and complete response rate (P<0.00001).
• ACD4C < 343 × 10^6/l significantly impacted 5-year progression-free survival and overall survival (P<0.00001 and P<0.00000001, respectively).
• Multivariate analysis identified ACD4C as an independent prognostic marker (hazard ratio=2.2, P<0.01).

Conclusions:

• A low absolute CD4+ T-cell count (ACD4C) at diagnosis is an independent poor prognostic marker in DLBCL patients.
• ACD4C can aid in predicting outcomes for DLBCL patients undergoing R-CHOP treatment.
• This finding may inform risk stratification and treatment decisions for DLBCL.