Absolute lymphocyte count is associated with survival in ovarian cancer independent of tumor-infiltrating lymphocytes
Date
2012-02-27
Authors
Milne, Katy
Alexander, Cheryl
Webb, John R
Sun, Winnie
Dillon, Kristy
Kalloger, Steve E
Gilks, C. Blake
Clarke, Blaise
Köbel, Martin
Nelson, Brad H
Journal Title
Journal ISSN
Volume Title
Publisher
BioMed Central
Abstract
Abstract
Background: The immune system strongly influences outcome in patients with ovarian cancer. In particular, the
absolute lymphocyte count in peripheral blood (ALC) and the presence of tumor-infiltrating lymphocytes (TIL) have
each been associated with favourable prognosis. However, the mechanistic relationships between ALC, TIL and
prognosis are poorly understood. We hypothesized that high ALC values might be associated with stronger tumor
immunity as manifested by increased TIL, decreased tumor burden and longer survival.
Methods: ALC values were collected from patient records ≥ 2 years before, during or after primary treatment for
high-grade serous ovarian cancer (HGSC). Lymphocyte subsets were assessed in peripheral blood by flow
cytometry. CD8+ and CD20+ TIL were assessed by immunohistochemistry.
Results: Overall, patients had normal ALC values two or more years prior to diagnosis of HGSC. These values were
not predictive of disease severity or survival upon subsequent development of HGSC. Rather, ALC declined upon
development of HGSC in proportion to disease burden. This decline involved all lymphocyte subsets. ALC
increased following surgery, remained stable during chemotherapy, but rarely recovered to pre-diagnostic levels.
ALC values recorded at diagnosis did not correlate with CD8+ or CD20+ TIL but were associated with progressionfree
survival.
Conclusions: Patients with high intrinsic ALC values show no clinical or survival advantage upon subsequent
development of HGSC. ALC values at diagnosis are prognostic due to an association with disease burden rather
than TIL. Therapeutic enhancement of ALC may be necessary but not sufficient to improve survival in HGSC.
Description
BioMed Central
Keywords
Ovarian cancer, Tumor infiltrating lymphocytes, Prognosis, Tumor immunology
Citation
Milne et al.: Absolute lymphocyte count is associated with survival in ovarian cancer independent of tumor-infiltrating lymphocytes. Journal of Translational Medicine 2012 10:33.