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• W2896486729 abstract "To investigate the rate of lymphopenia after receiving definitive adjuvant chemoradiation therapy (CRT) for glioblastoma (GBM) patients and potential effects on clinical outcomes. We conducted a retrospective review of GBM patients treated with definitive adjuvant CRT at our institution covering a period from 2008 to 2016. We identified 96 patients with sufficient details regarding their treatment course as well as complete blood count with differential at approximately 1 month after completion of adjuvant CRT and subsequent follow-up information. Lymphopenia was determined as lymphocyte count <850 cells/μL (severe lymphophenia defined as lymphocyte count <400 cells/μL, mild-moderate lymphopenia≥400 cells/ μL and <850 cells/μL), while pancytopenia was determined as lymphopenia plus leukopenia (WBC<3.8x103/μL), anemia (RBC<4.2x106/μL), and thrombocytopenia (platelet<140x103). We measured overall survival (OS) as well as progression-free survival (PFS). We performed summary statistics on baseline patient characteristics as well as Kaplan-Meier analysis for outcomes with log-rank test to compare subgroups. Of the 96 patients, 51 (53.5%) were male, and 45 (46.9%) were female. Median age at start of RT was 61 years old (range 33 to 88). Median follow-up was 16.8 months (range 2.3 to 61.1). Seven (7.3%) patients were still alive at time of writing, of which five had evidence of recurrence, leaving only two (2.1%) which remained disease free. Lymphopenia at 1 month post-RT was observed in 55 (57.3%) of patients, of which 13 patients (13.5%) had severe lymphopenia. Four patients (4.2%) had lymphopenia occurring in the setting of pancytopenia. Median OS for all patients was 16.5 months, with 1 year OS at 69.8% and 2 year OS at 29.9%. When comparing subgroups of patients with lymphopenia vs without, there was no significant difference in OS or PFS. The median OS was 16.5 mos vs 18 mos, with 1 year OS at 67.3% vs 73.2%, and 2 year OS at 32.5% vs 26.9%, respectively (p=0.68). Median PFS for all patients was 6.7 months, with 1 year PFS at 25% and 2 year PFS at 7.3%. For patients with lymphopenia vs without, median PFS was 6.2 mos vs 6.9 mos, with 1 year PFS at 30.9% vs 17.1%, and 2 year PFS at 9.1% vs 4.9%, respectively (p=0.34). For patients with severe lymphopenia, overall survival was worse, with median OS of 8.4 mos, 1 year OS was 46.1% and 2 year OS was 15.3%, with significantly worse prognosis when compared to patients without lymphopenia (p=0.041) as well as with those with mild-moderate lymphopenia (p=0.024). Median PFS for severe lymphopenia patients was 5.5 mos, with 1 year PFS of 23.1% and 2 year PFS at 7.7% with no statistically significant difference amongst subgroup comparison (p>0.05). Severe lymphopenia appears to have a negative impact on overall survival for GBM patients and should be considered as a prognostic factor for clinical outcomes." @default.
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• W2896486729 date "2018-11-01" @default.
• W2896486729 modified "2023-10-02" @default.
• W2896486729 title "Severe Lymphopenia after Chemoradiation Treatment is Associated with Worse Survival in Patients with Newly Diagnosed GBM" @default.
• W2896486729 doi "https://doi.org/10.1016/j.ijrobp.2018.07.1050" @default.
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