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Early lymphocyte recovery as a prognostic indicator for high-risk Ewing sarcoma.
- Source :
-
Journal of pediatric hematology/oncology [J Pediatr Hematol Oncol] 2007 Jan; Vol. 29 (1), pp. 48-52. - Publication Year :
- 2007
-
Abstract
- Background: Increasing evidence suggests that lymphocyte recovery plays a major part in tumor control. Facilitating immune reconstitution might be a novel direction of cancer therapy. The purpose of this study was to determine if early lymphocyte recovery is an independent prognostic indicator for high-risk Ewing sarcoma outcome.<br />Results: Data of 24 Ewing sarcoma patients were analyzed (age, 3 to 50 y; median, 16.5; male to female, 16:8). The 5-year overall survival (OS) of the total population was 47.9% [10.6 standard error (SE)]. Patients were separated into 2 groups: prolonged lymphopenia versus early lymphocyte recovery, using a threshold absolute lymphocyte count (ALC) of > or =500 cells/microL on day 15. The majority (67%; n=16) of the patients had an ALC > or =500 cells/microL, and of these 10/16 are alive with a 5-year OS of 58.7% (13.2 SE). In contrast, 33% (n=8) of patients had an ALC <500 cells/microL on day 15 and only 2/8 are alive with a 5-year OS of 25% (15.3 SE). This difference was significant (P=0.007 using the log rank test). When comparing patients with metastatic disease, patients with an ALC-15 < 500 cells/microL had a median survival of 13 months, whereas patients with an ALC-15 > or =500 cells/microL had a median survival of 29.5 months. All patients had an ALC before chemotherapy of >1000 cells/microL. The difference was significant (P value=0.001 using the log rank test). Univariate analysis of platelet counts, age, sex, and absolute neutrophil count showed no statistically significant association with OS.<br />Conclusions: The data demonstrate that an ALC > or =500 cells/microL on day 15 of the first course of chemotherapy is an independent prognostic factor associated with superior OS in high-risk Ewing sarcoma.
- Subjects :
- Adolescent
Adult
Age Factors
Child
Child, Preschool
Combined Modality Therapy mortality
Disease-Free Survival
Female
Humans
Leukocyte Count
Male
Middle Aged
Platelet Count
Retrospective Studies
Risk Factors
Sarcoma, Ewing therapy
Sex Factors
Survival Rate
Lymphocytes
Recovery of Function
Sarcoma, Ewing blood
Sarcoma, Ewing mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1077-4114
- Volume :
- 29
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of pediatric hematology/oncology
- Publication Type :
- Academic Journal
- Accession number :
- 17230066
- Full Text :
- https://doi.org/10.1097/MPH.0b013e31802d3e3e