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Lymphoma

Lymphopenia assessed during routine follow-up after immunochemotherapy (R-CHOP) is a risk factor for predicting relapse in patients with diffuse large B-cell lymphoma

Leukemia volume 24, pages 1343–1349 (2010)Cite this article

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Abstract

A specific predictor during routine follow-up to ascertain risk for relapse after standard chemotherapy in non-Hodgkin's lymphoma (NHL) has not been identified. Thus, we studied absolute lymphocyte count (ALC) as a marker of poststandard chemotherapy (rituximab, cyclophosphamide, adriamycin, vincristine and prednisone (R-CHOP)) NHL relapse in patients with diffuse large B-cell lymphoma (DLBCL). ALC was obtained at the time of confirmed relapse and at last follow-up. From 2000 until 2006, 149 consecutive DLBCL patients, originally diagnosed, treated with R-CHOP and followed up at Mayo Clinic, Rochester, were included in this study. Patients at last follow-up without relapse (N=112) had a higher ALC compared with those with relapsed lymphoma ((N=37) median ALC × 109/l of 1.43 (range: 0.33–4.0) versus 0.67 (range: 0.18–1.98), P<0.0001, respectively). ALC at the time of confirmed relapse was a strong predictor for relapse with an area under the curve =0.91 (P<0.0001). An ALC <0.96 × 109/l at the time of confirmed relapse had a positive predictive value of 72% and a positive likelihood ratio of 7.4 to predict relapse after R-CHOP in DLBCL. Patients with an ALC⩾0.96 × 109/l (N=103) had a cumulative incidence of relapse of 6 versus 79% with an ALC <0.96 × 109/l (N=46) (P<0.0001). This study suggests that lymphopenia measured by ALC can be used as a marker to assess risk of DLBCL relapse during routine follow-up after standard chemotherapy.

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Authors and Affiliations

  1. Division of Hematology,

    L F Porrata, K Rsitow, D J Inwards, S M Ansell, I N Micallef, P B Johnston, T M Habermann, T E Witzig, J P Colgan, G S Nowakowski, C A Thompson & S N Markovic

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

    L F Porrata, K Rsitow, D J Inwards, S M Ansell, I N Micallef, P B Johnston, T M Habermann, T E Witzig, J P Colgan, G S Nowakowski, C A Thompson & S N Markovic

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  1. L F Porrata
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Correspondence to L F Porrata.

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Porrata, L., Rsitow, K., Inwards, D. et al. Lymphopenia assessed during routine follow-up after immunochemotherapy (R-CHOP) is a risk factor for predicting relapse in patients with diffuse large B-cell lymphoma. Leukemia 24, 1343–1349 (2010). https://doi.org/10.1038/leu.2010.108

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