Higher Absolute Lymphocyte Counts Predict Lower Mortality from Early-Stage Triple-Negative Breast Cancer

Details

• Alternative Title:
  Clin Cancer Res
• Personal Author:
  Afghahi, Anosheh ; Purington, Natasha ; Han, Summer S. ; Desai, Manisha ; Pierson, Emma ; Mathur, Maya B. ; Seto, Tina ; Thompson, Caroline A. ; Rigdon, Joseph ; Telli, Melinda L. ; Badve, Sunil S. ; Curtis, Christina N. ; West, Robert B. ; Horst, Kathleen ; Gomez, Scarlett L. ; Ford, James M. ; Sledge, George W. ; Kurian, Allison W.
• Description:
  Purpose:
  
  Tumor-infiltrating lymphocytes (TIL) in pretreatment biopsies are associated with improved survival in triple-negative breast cancer (TNBC). We investigated whether higher peripheral lymphocyte counts are associated with lower breast cancer–specific mortality (BCM) and overall mortality (OM) in TNBC.
  
  Experimental Design:
  
  Data on treatments and diagnostic tests from electronic medical records of two health care systems were linked with demographic, clinical, pathologic, and mortality data from the California Cancer Registry. Multivariable regression models adjusted for age, race/ethnicity, socioeconomic status, cancer stage, grade, neoadjuvant/adjuvant chemotherapy use, radiotherapy use, and germline BRCA1/2 mutations were used to evaluate associations between absolute lymphocyte count (ALC), BCM, and OM. For a subgroup with TIL data available, we explored the relationship between TILs and peripheral lymphocyte counts.
  
  Results:
  
  A total of 1,463 stage I–III TNBC patients were diagnosed from 2000 to 2014; 1, 113 (76%) received neoadjuvant/adjuvant chemotherapy within 1 year of diagnosis. Of 759 patients with available ALC data, 481 (63.4%) were ever lymphopenic (minimum ALC <1.0 K/µL). On multivariable analysis, higher minimum ALC, but not absolute neutrophil count, predicted lower OM [HR=0.23; 95% confidence interval (CI), 0.16– 0.35] and BCM (HR=0.19; CI, 0.11–0.34). Five-year probability of BCM was 15% for patients who were ever lymphopenic versus 4% for those who were not. An exploratory analysis (n=70) showed a significant association between TILs and higher peripheral lymphocyte counts during neoadjuvant chemotherapy.
  
  Conclusions:
  
  Higher peripheral lymphocyte counts predicted lower mortality from early-stage, potentially curable TNBC, suggesting that immune function may enhance the effectiveness of early TNBC treatment.
  
  
• Subjects:
  Article
• Source:
  Clin Cancer Res. 24(12):2851-2858
• Pubmed ID:
  29581131
• Pubmed Central ID:
  PMC6366842
• Document Type:
  Journal Article
• Funding:
  HHSN261201000140C/CA/NCI NIH HHS/United States ; HHSN261201000035C/CA/NCI NIH HHS/United States ; KL2 TR001444/TR/NCATS NIH HHS/United States ; U58 DP000807/DP/NCCDPHP CDC HHS/United States ; HHSN261201000035I/CA/NCI NIH HHS/United States ; UL1 RR025744/RR/NCRR NIH HHS/United States ; HHSN261201000034C/CA/NCI NIH HHS/United States ; P30 CA124435/CA/NCI NIH HHS/United States
• Volume:
  24
• Issue:
  12
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:09205e889a76b027556f0dc6e9068cc80066ac16d0c62eaccc5b5d4279591942
• Download URL:
  https://stacks.cdc.gov/view/cdc/79372/cdc_79372_DS1.pdf
• File Type:
  [PDF - 522.05 KB ]