Department of Medical Oncology, Centre Léon Bérard, 28 rue Laennec, Lyon 69008, France.
Eur J Cancer. 2013 May;49(7):1673-82. doi: 10.1016/j.ejca.2012.11.028. Epub 2012 Dec 19.
Low lymphocyte count is a prognostic factor in cancer patients including metastatic breast cancer patients (MBC) but the relative role of each lymphocyte subtype is unclear in MBC.
The impact of lymphocyte subsets was analysed in two prospective MBC patients' cohorts. Cohort A patients (n=103) were included before the first line of chemotherapy and cohort B patients (n=101) were included after at least one line of chemotherapy. Extensive phenotypic analyses were performed on fresh whole blood. Plasma cytokines levels were measured using commercially available Luminex-based multiplex kits. Prognostic value of lymphocyte subsets and circulating cytokines was analysed.
In both cohorts, severe lymphopaenia (<0.7 Giga/L) correlated with poor overall survival (OS) (median OS: 6.6 months versus 21.7 months in cohort A and 4.5 versus 9 months in cohort B). CD8(+), CD19(+) and CD56(+) T cell counts had no significant prognostic value for OS. After stratification (≤0.2, [0.20-0.45], >0.45 Giga/L), CD4 lymphopaenia appeared to be correlated with poor OS in both cohorts. Furthermore, severe CD4(+) lymphopaenia (≤0.2 Giga/L) was strongly correlated with poor OS in both cohorts (1.2 months versus 24.9 months in cohort A and 5.7 versus 13.1 months in cohort B). In multivariate analysis, after stratification CD4(+) lymphopaenia appeared to be an independent prognostic factor for OS in both cohorts. CD4(+) lymphopaenia correlated with low plasmatic levels of CCL22 that might directly contribute to CD4(+) lymphopaenia.
CD4(+) lymphopaenia was associated with reduced OS in MBC patients regardless of the chemotherapy line. Decreased levels of plasmatic CCL22 may contribute to CD4(+) lymphopaenia.
低淋巴细胞计数是癌症患者（包括转移性乳腺癌患者）的预后因素，但在转移性乳腺癌患者中，每种淋巴细胞亚群的相对作用尚不清楚。
在两个前瞻性转移性乳腺癌患者队列中分析了淋巴细胞亚群的影响。队列 A 患者（n=103）在一线化疗前入组，队列 B 患者（n=101）在至少一线化疗后入组。对新鲜全血进行广泛的表型分析。使用商业上可用的基于 Luminex 的多重试剂盒测量血浆细胞因子水平。分析淋巴细胞亚群和循环细胞因子的预后价值。
在两个队列中，严重淋巴细胞减少症（<0.7 吉/升）与总生存（OS）不良相关（队列 A 的中位 OS：6.6 个月与 21.7 个月，队列 B 的 4.5 个月与 9 个月）。CD8（+）、CD19（+）和 CD56（+）T 细胞计数对 OS 无显著预后价值。分层后（≤0.2、[0.20-0.45]、>0.45 吉/升），CD4 淋巴细胞减少症似乎与两个队列的 OS 不良相关。此外，严重的 CD4（+）淋巴细胞减少症（≤0.2 吉/升）与两个队列的 OS 不良密切相关（队列 A 中 1.2 个月与 24.9 个月，队列 B 中 5.7 个月与 13.1 个月）。在多变量分析中，分层后，CD4（+）淋巴细胞减少症似乎是两个队列 OS 的独立预后因素。CD4（+）淋巴细胞减少症与低血浆 CCL22 水平相关，这可能直接导致 CD4（+）淋巴细胞减少症。
无论化疗线如何，CD4（+）淋巴细胞减少症与转移性乳腺癌患者的 OS 降低相关。血浆 CCL22 水平降低可能导致 CD4（+）淋巴细胞减少症。
