Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Letter to the Editor
  • Published:

Reply to ‘Claimed association of absolute lymphocyte count with therapeutic efficacy of radio-immunotherapy in patients with indolent lymphoma cannot be verified in an independence data set’ by Mark J Bishton et al

Leukemia volume 22, pages 2260–2261 (2008)Cite this article

We read with interest the study by Bishton et al.1 evaluating the role of absolute lymphocyte count (ALC) on survival and response rate in a cohort of 35 patients with indolent non-Hodgkin lymphoma treated with 131I-rituximab. In contrast to our previous publication,2 Bishton et al. reported an improved time to progression and better likelihood to achieve a complete response in patient with an ALC <1.0 × 109/l after treated with radio-immunotherapy (RIT).

The pressing question based on the study by Bishton and co-workers and our study is if the ALC is the best marker of host immunity affecting survival in patients treated with RIT. The ALC, as a surrogate maker of host immunity has been reported to be a significant factor for survival for different hematological3 and solid tumor malignancies,3 at diagnosis,4 during standard chemotherapy,5 as well as after autologous stem cell transplantation.3 Moreover, ALC is a prognostic factor for survival not only in the adult setting, but also in the pediatric setting.6, 7 A limitation of the ALC is that the ALC does not identify the specific lymphocyte subset affecting survival. Besides both studies being retrospective, a major limitation of both studies is the lack of lymphocyte subset analysis to further delineate which lymphocyte analysis might affect survival post-RIT and by which immunological mechanism.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Bishton MJ, Hicks RJ, Prince HM, Ritchie DS, Wolf M, Seymour JF . Claimed association of absolute lymphocyte count with therapeutic efficacy of radio-immunotherapy in patients with indolent lymphoma cannot be verified in an independence data set. Leukemia 2008.e-pub ahead of print 15 May 2008; doi: 10.1038/leu.2008.116.

    Article  CAS  PubMed  Google Scholar 

  2. Porrata LF, Ristow K, Witzig TE, Tunistra N, Habermann TM, Inwards DJ et al. Absolute lymphocyte count predicts therapeutic efficacy and survival at the time of radioimmunotherapy in patients with relapsed follicular lymphomas. Leukemia 2007; 21: 2554–2556.

    Article  CAS  PubMed  Google Scholar 

  3. Porrata LF, Markovic SN . Timely reconstitution of immune competence affects clinical outcome following autologous stem cell transplantation. Clin Exp Med 2004; 4: 78–85.

    Article  CAS  PubMed  Google Scholar 

  4. Siddiqui M, Ristoe K, Markovic SN, Witzig TE, Habermann TM, Colgan JP et al. Absolute lymphocyte count predicts overall survival in follicular lymphomas. Br J Haematol 2006; 134: 596–601.

    Article  PubMed  Google Scholar 

  5. Behl D, Porrata LF, Markovic SN, Letendre L, Pruthi RK, Hook CC et al. Absolute lymphocyte count recovery after induction chemotherapy predicts superior survival in acute myelogenous leukemia. Leukemia 2006; 20: 29–34.

    Article  CAS  PubMed  Google Scholar 

  6. De Angulo G, Hernandez M, Morales-Arias J, Herzog CE, Anderson P, Wolff J et al. Early lymphocyte recovery as a prognostic indicator for high-risk Ewing sarcoma. J Pediatr Hematol/Oncol 2007; 29: 48–52.

    Article  Google Scholar 

  7. De Angulo G, Yuen C, Palla SL, Anderson PM, Zweidler-Mckay PA . Absolute lymphocyte count is a novel prognostic indicator in ALL and AML: implication for risk stratification and future studies. Cancer 2008; 112: 407–415.

    Article  CAS  PubMed  Google Scholar 

  8. Kim DH, Baek JH, Chae YS, Kim YK, Kim HJ, Park YH et al. Absolute lymphocyte counts predicts response to chemotherapy and survival in diffuse large B-cell lymphoma. Leukemia 2007; 21: 2227–2230.

    Article  CAS  PubMed  Google Scholar 

  9. Plonquet A, Haioun C, Jais JP, Debard AL, Salles G, Bene MC et al. Peripheral blood natural killer cell count is associated with clinical outcome in patients with aaIPI 2-3 diffuse large B-cell lymphoma. Ann Oncol 2007; 18: 1209–1215.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Hematology/Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA

    L F Porrata, K Ristow, T E Witzig, T M Habermann, D J Inwards, S M Ansell, I N Micallef, P B Johnston & S N Markovic

  2. Department of Nuclear Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA

    N Tuinistra

Authors
  1. L F Porrata
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K Ristow
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. T E Witzig
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. N Tuinistra
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. T M Habermann
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. D J Inwards
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. S M Ansell
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. I N Micallef
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. P B Johnston
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. S N Markovic
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to L F Porrata.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Porrata, L., Ristow, K., Witzig, T. et al. Reply to ‘Claimed association of absolute lymphocyte count with therapeutic efficacy of radio-immunotherapy in patients with indolent lymphoma cannot be verified in an independence data set’ by Mark J Bishton et al. Leukemia 22, 2260–2261 (2008). https://doi.org/10.1038/leu.2008.117

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/leu.2008.117

Search

Advanced search

Quick links