Post-Treatment Neutrophil and Lymphocyte Counts Predict Progression-Free Survival Following First-Line Chemotherapy in Hodgkin’s Lymphoma
Hodgkin’s lymphoma carries an excellent prognosis with modern chemotherapy, but a significant proportion of patients remain refractory to or relapse after first-line treatment. Immunological changes post-treatment, such as chemotherapy-induced neutropenia (CIN) or lymphopenia, have shown prognostic...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
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MDPI AG
2023-02-01
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| Series: | Hematology Reports |
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| Online Access: | https://www.mdpi.com/2038-8330/15/1/12 |
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| author | Grace Fangmin Tan Siting Goh Esther Wei Yin Chang Ya Hwee Tan Jianbang Chiang Valerie Shiwen Yang Eileen Yi Ling Poon Nagavalli Somasundaram Mohamad Farid Bin Harunal Rashid Miriam Tao Soon Thye Lim Choon Kiat Ong Jason Yongsheng Chan |
| author_facet | Grace Fangmin Tan Siting Goh Esther Wei Yin Chang Ya Hwee Tan Jianbang Chiang Valerie Shiwen Yang Eileen Yi Ling Poon Nagavalli Somasundaram Mohamad Farid Bin Harunal Rashid Miriam Tao Soon Thye Lim Choon Kiat Ong Jason Yongsheng Chan |
| author_sort | Grace Fangmin Tan |
| collection | DOAJ |
| description | Hodgkin’s lymphoma carries an excellent prognosis with modern chemotherapy, but a significant proportion of patients remain refractory to or relapse after first-line treatment. Immunological changes post-treatment, such as chemotherapy-induced neutropenia (CIN) or lymphopenia, have shown prognostic significance in multiple tumor types. Our study aims to investigate the prognostic value of immunologic changes in Hodgkin’s lymphoma by examining the post-treatment lymphocyte count (pALC), neutrophil count (pANC) and the neutrophil-lymphocyte ratio (pNLR). Patients treated for classical Hodgkin’s lymphoma at the National Cancer Centre Singapore using ABVD-based regimens were retrospectively analyzed. An optimal cut-off value for high pANC, low pALC and high pNLR in predicting progression-free survival was determined by receiver operating curve analysis. Survival analysis was performed using the Kaplan–Meier method and multivariable Cox proportional models. Overall OS and PFS were excellent, with a 5-year OS of 99.2% and a 5-year PFS of 88.2%. Poorer PFS was associated with high pANC (HR 2.99, <i>p</i> = 0.0392), low pALC (HR 3.95, <i>p</i> = 0.0038) and high pNLR (<i>p</i> = 0.0078). In conclusion, high pANC, low pALC and high pNLR confer a poorer prognosis for Hodgkin’s lymphoma. Future studies should evaluate the potential of improving treatment outcomes by the adjustment of chemotherapy dose intensity based on post-treatment blood counts. |
| first_indexed | 2024-03-11T06:28:12Z |
| format | Article |
| id | doaj.art-8d375f648f6c41bcb63910bd11e45904 |
| institution | Directory Open Access Journal |
| issn | 2038-8330 |
| language | English |
| last_indexed | 2024-03-11T06:28:12Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Hematology Reports |
| spelling | doaj.art-8d375f648f6c41bcb63910bd11e459042023-11-17T11:22:35ZengMDPI AGHematology Reports2038-83302023-02-0115110811810.3390/hematolrep15010012Post-Treatment Neutrophil and Lymphocyte Counts Predict Progression-Free Survival Following First-Line Chemotherapy in Hodgkin’s LymphomaGrace Fangmin Tan0Siting Goh1Esther Wei Yin Chang2Ya Hwee Tan3Jianbang Chiang4Valerie Shiwen Yang5Eileen Yi Ling Poon6Nagavalli Somasundaram7Mohamad Farid Bin Harunal Rashid8Miriam Tao9Soon Thye Lim10Choon Kiat Ong11Jason Yongsheng Chan12Singhealth Internal Medicine Residency, Singapore General Hospital, Singapore 168753, SingaporeDivision of Medical Oncology, National Cancer Centre Singapore, Singapore 169610, SingaporeDivision of Medical Oncology, National Cancer Centre Singapore, Singapore 169610, SingaporeDivision of Medical Oncology, National Cancer Centre Singapore, Singapore 169610, SingaporeDivision of Medical Oncology, National Cancer Centre Singapore, Singapore 169610, SingaporeDivision of Medical Oncology, National Cancer Centre Singapore, Singapore 169610, SingaporeDivision of Medical Oncology, National Cancer Centre Singapore, Singapore 169610, SingaporeDivision of Medical Oncology, National Cancer Centre Singapore, Singapore 169610, SingaporeDivision of Medical Oncology, National Cancer Centre Singapore, Singapore 169610, SingaporeDivision of Medical Oncology, National Cancer Centre Singapore, Singapore 169610, SingaporeDivision of Medical Oncology, National Cancer Centre Singapore, Singapore 169610, SingaporeOncology Academic Clinical Program, Duke-NUS Medical School, Singapore 169857, SingaporeDivision of Medical Oncology, National Cancer Centre Singapore, Singapore 169610, SingaporeHodgkin’s lymphoma carries an excellent prognosis with modern chemotherapy, but a significant proportion of patients remain refractory to or relapse after first-line treatment. Immunological changes post-treatment, such as chemotherapy-induced neutropenia (CIN) or lymphopenia, have shown prognostic significance in multiple tumor types. Our study aims to investigate the prognostic value of immunologic changes in Hodgkin’s lymphoma by examining the post-treatment lymphocyte count (pALC), neutrophil count (pANC) and the neutrophil-lymphocyte ratio (pNLR). Patients treated for classical Hodgkin’s lymphoma at the National Cancer Centre Singapore using ABVD-based regimens were retrospectively analyzed. An optimal cut-off value for high pANC, low pALC and high pNLR in predicting progression-free survival was determined by receiver operating curve analysis. Survival analysis was performed using the Kaplan–Meier method and multivariable Cox proportional models. Overall OS and PFS were excellent, with a 5-year OS of 99.2% and a 5-year PFS of 88.2%. Poorer PFS was associated with high pANC (HR 2.99, <i>p</i> = 0.0392), low pALC (HR 3.95, <i>p</i> = 0.0038) and high pNLR (<i>p</i> = 0.0078). In conclusion, high pANC, low pALC and high pNLR confer a poorer prognosis for Hodgkin’s lymphoma. Future studies should evaluate the potential of improving treatment outcomes by the adjustment of chemotherapy dose intensity based on post-treatment blood counts.https://www.mdpi.com/2038-8330/15/1/12Hodgkin’s lymphomaABVDlymphopenianeutropeniaprognosis |
| spellingShingle | Grace Fangmin Tan Siting Goh Esther Wei Yin Chang Ya Hwee Tan Jianbang Chiang Valerie Shiwen Yang Eileen Yi Ling Poon Nagavalli Somasundaram Mohamad Farid Bin Harunal Rashid Miriam Tao Soon Thye Lim Choon Kiat Ong Jason Yongsheng Chan Post-Treatment Neutrophil and Lymphocyte Counts Predict Progression-Free Survival Following First-Line Chemotherapy in Hodgkin’s Lymphoma Hematology Reports Hodgkin’s lymphoma ABVD lymphopenia neutropenia prognosis |
| title | Post-Treatment Neutrophil and Lymphocyte Counts Predict Progression-Free Survival Following First-Line Chemotherapy in Hodgkin’s Lymphoma |
| title_full | Post-Treatment Neutrophil and Lymphocyte Counts Predict Progression-Free Survival Following First-Line Chemotherapy in Hodgkin’s Lymphoma |
| title_fullStr | Post-Treatment Neutrophil and Lymphocyte Counts Predict Progression-Free Survival Following First-Line Chemotherapy in Hodgkin’s Lymphoma |
| title_full_unstemmed | Post-Treatment Neutrophil and Lymphocyte Counts Predict Progression-Free Survival Following First-Line Chemotherapy in Hodgkin’s Lymphoma |
| title_short | Post-Treatment Neutrophil and Lymphocyte Counts Predict Progression-Free Survival Following First-Line Chemotherapy in Hodgkin’s Lymphoma |
| title_sort | post treatment neutrophil and lymphocyte counts predict progression free survival following first line chemotherapy in hodgkin s lymphoma |
| topic | Hodgkin’s lymphoma ABVD lymphopenia neutropenia prognosis |
| url | https://www.mdpi.com/2038-8330/15/1/12 |
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