Lymphopenia predicts preclinical relapse in the routine follow-up of patients with diffuse large B-cell lymphoma

Abstract

The absolute lymphocyte count (ALC) has been reported to predict relapse in diffuse large B-cell lymphoma (DLBCL). We performed the present study to determine whether the ALC could identify preclinical relapse during routine follow-up. Among all 148 patients analyzed, 39 patients exhibited relapse. Patients without relapse had a higher ALC compared with those with proven relapse at the time of relapse as well as 1 and 3 months before relapse. Low ALC (< 950/μL) at 1 and 3 months before relapse had a positive predictive value of 74.2% and 69.0% and a negative predictive value of 86.3% and 84.0%, respectively, to predict relapse. Low ALC at both 1 and 3 months before relapse was significantly associated with relapse by univariate and multivariate analysis. Our data suggest the potential of lymphopenia to detect preclinical relapse in DLBCL. This may help to identify patients requiring salvage chemotherapy at the time of minimal disease rather than clinically overt relapse.

Keywords::

• Diffuse large B-cell lymphoma
• absolute lymphocyte count
• lymphopenia
• relapse
• follow-up

Acknowledgements

We thank Prof. Pingyan Chen and Lizhi Zhou for help in statistical analysis.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article at www.informahealthcare.com/lal.

This work was supported by the Science and Technology Project of Guangdong Province (Grant No. 2010B050700020), the Natural Science Foundation of Guangdong Province (Grant No. S2011010003790) and the Science and Technology Project of Guangzhou City (Grant No. 12C22121553).

Supplementary material available online

Figure showing further results.