Absolute lymphocyte count: A potential prognostic factor for Merkel cell carcinoma

Matthew E. Johnson, Fang Zhu, Tianyu Li, Hong Wu, Thomas J. Galloway, Jeffrey M. Farma, Clifford S. Perlis, Aruna Turaka

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Background Absolute lymphocyte count (ALC) is a laboratory value commonly obtained during workup of patients with Merkel cell carcinoma (MCC). Objective We report the prognostic impact of ALC as a surrogate of immune status in MCC. Methods A complete blood cell count was available for 64 patients with MCC in the month before definitive surgery, chemotherapy, or radiation. Statistical analysis was performed with classification and regression tree analysis, log rank test, and Cox model. Results Median overall survival (OS) for the cohort was 97 months. Median OS for patients with an ALC less than 1.1 k/mm3 was 18.8 versus 110.1 months for those with ALC greater than or equal to 1.1 k/mm3 (P =.002, hazard ratio 0.29). Multivariate analysis of OS controlling for ALC, sex, stage, adjuvant chemotherapy, hematologic malignancy, and immunosuppression demonstrated ALC as a prognostic factor (P =.03). Disease-free survival at 36 months for ALC less than 1.1 k/mm3 was 26.9% versus 64.4% for those with ALC greater than or equal to 1.1 k/mm 3 (P =.01). ALC was not a significant predictor for disease-free survival on multivariate analysis (P =.12). Limitations This is a single-institution retrospective data set. Conclusion ALC is associated with OS but not disease-free survival in MCC using a threshold of less than 1.1 k/mm3. This test may provide additional prognostic information for patients with MCC.

Original languageEnglish
Pages (from-to)1028-1035
Number of pages8
JournalJournal of the American Academy of Dermatology
Volume70
Issue number6
DOIs
StatePublished - Jun 2014

Keywords

  • Merkel cell carcinoma
  • absolute lymphocyte count
  • immune function
  • skin cancer
  • skin neoplasm

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