TY - JOUR
T1 - Absolute lymphocyte count
T2 - A potential prognostic factor for Merkel cell carcinoma
AU - Johnson, Matthew E.
AU - Zhu, Fang
AU - Li, Tianyu
AU - Wu, Hong
AU - Galloway, Thomas J.
AU - Farma, Jeffrey M.
AU - Perlis, Clifford S.
AU - Turaka, Aruna
PY - 2014/6
Y1 - 2014/6
N2 - Background Absolute lymphocyte count (ALC) is a laboratory value commonly obtained during workup of patients with Merkel cell carcinoma (MCC). Objective We report the prognostic impact of ALC as a surrogate of immune status in MCC. Methods A complete blood cell count was available for 64 patients with MCC in the month before definitive surgery, chemotherapy, or radiation. Statistical analysis was performed with classification and regression tree analysis, log rank test, and Cox model. Results Median overall survival (OS) for the cohort was 97 months. Median OS for patients with an ALC less than 1.1 k/mm3 was 18.8 versus 110.1 months for those with ALC greater than or equal to 1.1 k/mm3 (P =.002, hazard ratio 0.29). Multivariate analysis of OS controlling for ALC, sex, stage, adjuvant chemotherapy, hematologic malignancy, and immunosuppression demonstrated ALC as a prognostic factor (P =.03). Disease-free survival at 36 months for ALC less than 1.1 k/mm3 was 26.9% versus 64.4% for those with ALC greater than or equal to 1.1 k/mm 3 (P =.01). ALC was not a significant predictor for disease-free survival on multivariate analysis (P =.12). Limitations This is a single-institution retrospective data set. Conclusion ALC is associated with OS but not disease-free survival in MCC using a threshold of less than 1.1 k/mm3. This test may provide additional prognostic information for patients with MCC.
AB - Background Absolute lymphocyte count (ALC) is a laboratory value commonly obtained during workup of patients with Merkel cell carcinoma (MCC). Objective We report the prognostic impact of ALC as a surrogate of immune status in MCC. Methods A complete blood cell count was available for 64 patients with MCC in the month before definitive surgery, chemotherapy, or radiation. Statistical analysis was performed with classification and regression tree analysis, log rank test, and Cox model. Results Median overall survival (OS) for the cohort was 97 months. Median OS for patients with an ALC less than 1.1 k/mm3 was 18.8 versus 110.1 months for those with ALC greater than or equal to 1.1 k/mm3 (P =.002, hazard ratio 0.29). Multivariate analysis of OS controlling for ALC, sex, stage, adjuvant chemotherapy, hematologic malignancy, and immunosuppression demonstrated ALC as a prognostic factor (P =.03). Disease-free survival at 36 months for ALC less than 1.1 k/mm3 was 26.9% versus 64.4% for those with ALC greater than or equal to 1.1 k/mm 3 (P =.01). ALC was not a significant predictor for disease-free survival on multivariate analysis (P =.12). Limitations This is a single-institution retrospective data set. Conclusion ALC is associated with OS but not disease-free survival in MCC using a threshold of less than 1.1 k/mm3. This test may provide additional prognostic information for patients with MCC.
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U2 - 10.1016/j.jaad.2014.01.890
DO - 10.1016/j.jaad.2014.01.890
M3 - Article
C2 - 24666998
AN - SCOPUS:84901236890
SN - 0190-9622
VL - 70
SP - 1028
EP - 1035
JO - Journal of the American Academy of Dermatology
JF - Journal of the American Academy of Dermatology
IS - 6
ER -