Moreira Alvaro, Leisgang Waltraud, Schuler Gerold, Heinzerling Lucie
Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany.
Immunotherapy. 2017 Jan;9(2):115-121. doi: 10.2217/imt-2016-0138.
The prognostic role of eosinophils in cancer has been controversial. Some entities such as gastrointestinal cancers show a better survival, while others such as Hodgkin's lymphoma a worse survival in patients with eosinophilia. Patients who exhibited an increase in eosinophils upon therapy with ipilimumab or pembrolizumab were shown to survive longer. We wanted to investigate whether eosinophilia is a prognostic marker in metastatic melanoma.
In total, 173 patients with metastatic melanoma from our data base (median age 60 years; n = 86 with immunotherapy, n = 87 without immunotherapy) were analyzed for eosinophil counts and survival over the course of 12 years. Eosinophilic count was detected by peripheral blood smear. The ethical committee had approved this retrospective study.
Melanoma patients with eosinophilia at any point in their course of disease show a trend toward longer survival independently of their therapy. There is a statistically significant difference for the patients who survive at least 12 months (p < 0.005). In patients with checkpoint inhibitor therapy, survival was significantly prolonged in every patient with eosinophilia (p < 0.05). Furthermore, 69% of the patients treated with immunotherapy experienced at least once an eosinophilia of 5% or greater compared with 46% in the immunotherapy naive-group; for an eosinophilia of 10% values were 30 and 9%, respectively. Interestingly, in patients with more than 20% eosinophils (n = 7) survival was prolonged with a median of 35 months (range 19-60 months) as compared with 16 months (range 1-117 months).
Eosinophilia is a prognostic marker in patients with metastatic melanoma.
嗜酸性粒细胞在癌症中的预后作用一直存在争议。某些实体瘤如胃肠道癌症患者生存率较高，而其他疾病如霍奇金淋巴瘤患者，嗜酸性粒细胞增多时生存率较低。接受伊匹单抗或派姆单抗治疗后嗜酸性粒细胞增多的患者生存期更长。我们想研究嗜酸性粒细胞增多是否为转移性黑色素瘤的预后标志物。
对我们数据库中173例转移性黑色素瘤患者（中位年龄60岁；86例接受免疫治疗，87例未接受免疫治疗）进行分析，统计其12年病程中的嗜酸性粒细胞计数和生存率。通过外周血涂片检测嗜酸性粒细胞计数。该回顾性研究已获伦理委员会批准。
在疾病过程中任何时间点出现嗜酸性粒细胞增多的黑色素瘤患者，无论接受何种治疗，均有生存期延长的趋势。生存期至少12个月的患者存在统计学显著差异（p < 0.005）。在接受检查点抑制剂治疗的患者中，每例嗜酸性粒细胞增多的患者生存期均显著延长（p < 0.05）。此外，69%接受免疫治疗的患者至少有一次嗜酸性粒细胞增多达5%或更高，而未接受免疫治疗组这一比例为46%；嗜酸性粒细胞增多达10%时，相应比例分别为30%和9%。有趣的是，嗜酸性粒细胞超过20%的患者（n = 7）生存期延长，中位生存期为35个月（范围19 - 60个月），而其他患者为16个月（范围1 - 117个月）。
嗜酸性粒细胞增多是转移性黑色素瘤患者的预后标志物。
