Hematology Reports (Feb 2023)

Post-Treatment Neutrophil and Lymphocyte Counts Predict Progression-Free Survival Following First-Line Chemotherapy in Hodgkin’s Lymphoma

  • Grace Fangmin Tan,
  • Siting Goh,
  • Esther Wei Yin Chang,
  • Ya Hwee Tan,
  • Jianbang Chiang,
  • Valerie Shiwen Yang,
  • Eileen Yi Ling Poon,
  • Nagavalli Somasundaram,
  • Mohamad Farid Bin Harunal Rashid,
  • Miriam Tao,
  • Soon Thye Lim,
  • Choon Kiat Ong,
  • Jason Yongsheng Chan

DOI
https://doi.org/10.3390/hematolrep15010012
Journal volume & issue
Vol. 15, no. 1
pp. 108 – 118

Abstract

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Hodgkin’s lymphoma carries an excellent prognosis with modern chemotherapy, but a significant proportion of patients remain refractory to or relapse after first-line treatment. Immunological changes post-treatment, such as chemotherapy-induced neutropenia (CIN) or lymphopenia, have shown prognostic significance in multiple tumor types. Our study aims to investigate the prognostic value of immunologic changes in Hodgkin’s lymphoma by examining the post-treatment lymphocyte count (pALC), neutrophil count (pANC) and the neutrophil-lymphocyte ratio (pNLR). Patients treated for classical Hodgkin’s lymphoma at the National Cancer Centre Singapore using ABVD-based regimens were retrospectively analyzed. An optimal cut-off value for high pANC, low pALC and high pNLR in predicting progression-free survival was determined by receiver operating curve analysis. Survival analysis was performed using the Kaplan–Meier method and multivariable Cox proportional models. Overall OS and PFS were excellent, with a 5-year OS of 99.2% and a 5-year PFS of 88.2%. Poorer PFS was associated with high pANC (HR 2.99, p = 0.0392), low pALC (HR 3.95, p = 0.0038) and high pNLR (p = 0.0078). In conclusion, high pANC, low pALC and high pNLR confer a poorer prognosis for Hodgkin’s lymphoma. Future studies should evaluate the potential of improving treatment outcomes by the adjustment of chemotherapy dose intensity based on post-treatment blood counts.

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