Peripheral Blood Lymphocyte Percentage May Predict Chemotolerance and Survival in Patients with Advanced Pancreatic Cancer. Association between Adaptive Immunity and Nutritional State
Pancreatic Carcinoma (PC) cells have the ability to induce patient immunosuppression and to escape immunosurveillance. Low circulating lymphocytes are associated with an advanced stage of PC and reduced survival. Blood lymphocytes expressed as a percentage of Total White Blood Cells (L% TWBC) could...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-08-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/28/5/285 |
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| author | Roberto Aquilani Silvia Brugnatelli Roberto Maestri Federica Boschi Beatrice Filippi Lorenzo Perrone Annalisa Barbieri Daniela Buonocore Maurizia Dossena Manuela Verri |
| author_facet | Roberto Aquilani Silvia Brugnatelli Roberto Maestri Federica Boschi Beatrice Filippi Lorenzo Perrone Annalisa Barbieri Daniela Buonocore Maurizia Dossena Manuela Verri |
| author_sort | Roberto Aquilani |
| collection | DOAJ |
| description | Pancreatic Carcinoma (PC) cells have the ability to induce patient immunosuppression and to escape immunosurveillance. Low circulating lymphocytes are associated with an advanced stage of PC and reduced survival. Blood lymphocytes expressed as a percentage of Total White Blood Cells (L% TWBC) could predict chemotolerance (n° of tolerated cycles), survival time and Body Weight (BW) more effectively than lymphocytes expressed as an absolute value (L<sub>AB</sub> > 1500 n°/mm<sup>3</sup>) or lymphocytes >22%, which is the lowest limit of normal values in our laboratory. Forty-one patients with advanced PC, treated with chemotherapy, were selected for this observational retrospective study. Patients were evaluated at baseline (pre-chemotherapy), and at 6, 12 and 18 months, respectively, after diagnosis of PC. The study found L ≥ 29.7% to be a better predictor of survival (COX model, using age, sex, BW, serum creatinine, bilirubin and lymphocytes as covariates), chemotolerance (r = +0.50, <i>p</i> = 0.001) and BW (r = +0.35, <i>p</i> = 0.027) than L<sub>AB</sub> > 1500 or L > 22%. BW did not significantly correlate with chemotolerance or survival. The preliminary results of this study suggest that L ≥ 29.7% is more effective than L<sub>AB</sub> > 1500 or L > 22% at predicting chemotolerance, survival time and nutritional status. A possible impact of nutritional status on chemotherapy and survival seems to be lymphocyte-mediated given the association between BW and L%. This study may serve as the basis for future research to explore whether nutritional interventions can improve lymphopenia, and if so, how this may be possible. |
| first_indexed | 2024-03-10T06:38:35Z |
| format | Article |
| id | doaj.art-6ec843ec780040c6be8a3bfeebd78d9e |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-10T06:38:35Z |
| publishDate | 2021-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-6ec843ec780040c6be8a3bfeebd78d9e2023-11-22T17:54:22ZengMDPI AGCurrent Oncology1198-00521718-77292021-08-012853280329610.3390/curroncol28050285Peripheral Blood Lymphocyte Percentage May Predict Chemotolerance and Survival in Patients with Advanced Pancreatic Cancer. Association between Adaptive Immunity and Nutritional StateRoberto Aquilani0Silvia Brugnatelli1Roberto Maestri2Federica Boschi3Beatrice Filippi4Lorenzo Perrone5Annalisa Barbieri6Daniela Buonocore7Maurizia Dossena8Manuela Verri9Department of Biology and Biotechnology “Lazzaro Spallanzani”, University of Pavia, 27100 Pavia, ItalyMedical Oncology Division, Fondazione IRCCS, Policlinico San Matteo, 27100 Pavia, ItalyDepartment of Biomedical Engineering of the Montescano Institute, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, ItalyDepartment of Drug Sciences, University of Pavia, 27100 Pavia, ItalyMedical Oncology Division, Fondazione IRCCS, Policlinico San Matteo, 27100 Pavia, ItalyMedical Oncology Division, Fondazione IRCCS, Policlinico San Matteo, 27100 Pavia, ItalyDepartment of Drug Sciences, University of Pavia, 27100 Pavia, ItalyDepartment of Biology and Biotechnology “Lazzaro Spallanzani”, University of Pavia, 27100 Pavia, ItalyDepartment of Biology and Biotechnology “Lazzaro Spallanzani”, University of Pavia, 27100 Pavia, ItalyDepartment of Biology and Biotechnology “Lazzaro Spallanzani”, University of Pavia, 27100 Pavia, ItalyPancreatic Carcinoma (PC) cells have the ability to induce patient immunosuppression and to escape immunosurveillance. Low circulating lymphocytes are associated with an advanced stage of PC and reduced survival. Blood lymphocytes expressed as a percentage of Total White Blood Cells (L% TWBC) could predict chemotolerance (n° of tolerated cycles), survival time and Body Weight (BW) more effectively than lymphocytes expressed as an absolute value (L<sub>AB</sub> > 1500 n°/mm<sup>3</sup>) or lymphocytes >22%, which is the lowest limit of normal values in our laboratory. Forty-one patients with advanced PC, treated with chemotherapy, were selected for this observational retrospective study. Patients were evaluated at baseline (pre-chemotherapy), and at 6, 12 and 18 months, respectively, after diagnosis of PC. The study found L ≥ 29.7% to be a better predictor of survival (COX model, using age, sex, BW, serum creatinine, bilirubin and lymphocytes as covariates), chemotolerance (r = +0.50, <i>p</i> = 0.001) and BW (r = +0.35, <i>p</i> = 0.027) than L<sub>AB</sub> > 1500 or L > 22%. BW did not significantly correlate with chemotolerance or survival. The preliminary results of this study suggest that L ≥ 29.7% is more effective than L<sub>AB</sub> > 1500 or L > 22% at predicting chemotolerance, survival time and nutritional status. A possible impact of nutritional status on chemotherapy and survival seems to be lymphocyte-mediated given the association between BW and L%. This study may serve as the basis for future research to explore whether nutritional interventions can improve lymphopenia, and if so, how this may be possible.https://www.mdpi.com/1718-7729/28/5/285advanced pancreatic cancerimpaired adaptive immune responsechemotolerancesurvivalnutritional status |
| spellingShingle | Roberto Aquilani Silvia Brugnatelli Roberto Maestri Federica Boschi Beatrice Filippi Lorenzo Perrone Annalisa Barbieri Daniela Buonocore Maurizia Dossena Manuela Verri Peripheral Blood Lymphocyte Percentage May Predict Chemotolerance and Survival in Patients with Advanced Pancreatic Cancer. Association between Adaptive Immunity and Nutritional State Current Oncology advanced pancreatic cancer impaired adaptive immune response chemotolerance survival nutritional status |
| title | Peripheral Blood Lymphocyte Percentage May Predict Chemotolerance and Survival in Patients with Advanced Pancreatic Cancer. Association between Adaptive Immunity and Nutritional State |
| title_full | Peripheral Blood Lymphocyte Percentage May Predict Chemotolerance and Survival in Patients with Advanced Pancreatic Cancer. Association between Adaptive Immunity and Nutritional State |
| title_fullStr | Peripheral Blood Lymphocyte Percentage May Predict Chemotolerance and Survival in Patients with Advanced Pancreatic Cancer. Association between Adaptive Immunity and Nutritional State |
| title_full_unstemmed | Peripheral Blood Lymphocyte Percentage May Predict Chemotolerance and Survival in Patients with Advanced Pancreatic Cancer. Association between Adaptive Immunity and Nutritional State |
| title_short | Peripheral Blood Lymphocyte Percentage May Predict Chemotolerance and Survival in Patients with Advanced Pancreatic Cancer. Association between Adaptive Immunity and Nutritional State |
| title_sort | peripheral blood lymphocyte percentage may predict chemotolerance and survival in patients with advanced pancreatic cancer association between adaptive immunity and nutritional state |
| topic | advanced pancreatic cancer impaired adaptive immune response chemotolerance survival nutritional status |
| url | https://www.mdpi.com/1718-7729/28/5/285 |
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