Department of Medicine, University of Minnesota, Minneapolis, USA.
Am J Hematol. 2010 Mar;85(3):160-3. doi: 10.1002/ajh.21618.
The prognostic significance of the peripheral blood absolute lymphocyte count (ALC) has been carefully examined in lymphoid malignancies, but the importance of the baseline ALC in chronic myeloid neoplasms is less clear. In a recent analysis of myelodysplastic syndromes (MDS) associated with deletion of chromosome 5q, we observed that an ALC < 1.2x 10(9) cells/L at diagnosis is independently associated with poorer survival. Clinicopathological data from 503 patients with non-del(5q) MDS evaluated at Mayo Clinic between 1996 and 2007 were reviewed to determine the prognostic impact of ALC at diagnosis in non-del(5q) MDS. Patients with MDS and an ALC at diagnosis > or =1.2x 10(9) (N = 248) experienced a superior overall survival (OS) compared with patients with an ALC < 1.2x 10(9)/L (N = 255, median OS of 26.6 months versus 18.5 months, P < 0.001, respectively). ALC at diagnosis was an independent predictor for OS when compared with the International Prognostic Scoring System and the WHO-based Prognostic Scoring System. This study suggests that ALC at diagnosis is a prognostic factor for OS in MDS, and argues in favor of further studies to assess the role of host immunity in MDS clinical outcomes.
外周血绝对淋巴细胞计数（ALC）的预后意义在淋巴恶性肿瘤中已被仔细研究，但在慢性髓系肿瘤中基线 ALC 的重要性尚不清楚。在最近对伴有 5q 染色体缺失的骨髓增生异常综合征（MDS）的分析中，我们观察到诊断时 ALC<1.2x10(9)细胞/L 与较差的生存独立相关。对 1996 年至 2007 年间在梅奥诊所接受评估的 503 例非 del(5q) MDS 患者的临床病理数据进行了回顾性分析，以确定非 del(5q) MDS 患者诊断时 ALC 的预后影响。诊断时 ALC > =1.2x10(9)的 MDS 患者（N = 248）与 ALC < 1.2x10(9)/L 的患者（N = 255）相比，总体生存率（OS）更高（中位 OS 分别为 26.6 个月和 18.5 个月，P < 0.001）。与国际预后评分系统和基于世卫组织的预后评分系统相比，诊断时的 ALC 是 OS 的独立预测因素。这项研究表明，诊断时的 ALC 是 MDS 患者 OS 的预后因素，并支持进一步研究宿主免疫在 MDS 临床结果中的作用。
