Interindividual differences in the circadian hematologic time structure of cancer patients

The complete hematologic blood cell count of 11 patients with advanced cancer were determined on 14 occasions, every 4 hr over 36-48 hr. Oral temperature was also measured at the same times as blood sampling. Five patients had breast cancer, five had ovarian cancer and one a leiomyosarcoma. Circadian rhythms were detected by the cosinor method for seven hematologic variables (red blood cells, hemoglobin, hematocrit, white blood cells, neutrophils, lymphocytes, platelets) and for oral temperature in the whole group of patients. All acrophases were located between 1300 and 1700 hr, except for lymphocytes (2100 hr). A rhythm with a period of 8 hr was validated for lymphocytes and monocytes. Validated or estimated amplitudes and acrophases were closely similar in both breast and ovarian cancer subgroups. Individual cosinor analyses documented large differences from patient to patient, which were accounted for by differences in performance status. Thus, subjects with poor performance status and rapidly progressive disease had very few validated rhythms as compared to those patients with good performance status. As a result a statistically significant correlation was found between the number of validated hematologic circadian rhythms and the performance status (r = -0.88; P less than 0.01).