J Korean Med Sci.  2007 Sep;22(Suppl):S122-S128. 10.3346/jkms.2007.22.S.S122.

Analysis of Changes in the Total Lymphocyte and Eosinophil Count during Immunotherapy for Metastatic Renal Cell Carcinoma: Correlation with Response and Survival

• Jeong IG
• Han KS
• Joung JY
• Choi WS
• Hwang SS
• Yang SO
• Seo HK
• Chung J
• Lee KH

• KMID: 1785800
• DOI: http://doi.org/10.3346/jkms.2007.22.S.S122

Abstract

The aims of this study were to analyze lymphocyte and eosinophil counts in consecutive peripheral blood samples taken during immunotherapy for metastatic renal cell carcinoma (mRCC) and to correlate the findings with objective response and survival. A total of 40 patients with mRCC who received immunotherapy with interleukin-2, interferon-alpha, and 5-fluorouracil were analyzed. Objective responses were observed in 14 patients, including 2 (5%) who showed a complete response (CR) and 12 (30%) who showed a partial response (PR). Eleven patients (27%) achieved stable disease (SD), and 15 patients (38%) had progressive disease (PD). Changes from baseline in the total lymphocyte counts were significantly higher in the responding patients (CR+PR+SD) than in the non-responding patients (PD) (p=0.017), but no difference was seen in the total eosinophil counts (p=0.275). Univariate analysis identified the Eastern Cooperative Oncology Group (ECOG) performance status (p=0.017), the presence of a primary renal tumor (p<0.001) and the peripheral lymphocyte counts at week 4 (p=0.034) as prognostic factors, but a low ECOG performance status (p=0.003) and the presence of a primary renal tumor (p=0.001) were identified as independent poor prognostic factors by multivariate analysis. This study provides further evidence that changes in blood lymphocyte counts may serve as an objective indicator of objective responses.

Keyword

Renal Cell Carcinoma; Interleukin-2; Interferon-alpha; Lymphocytes; Eosinophils

MeSH Terms

Adult
Aged
Carcinoma, Renal Cell/blood/*immunology/secondary/*therapy
Eosinophils
Female
Fluorouracil/administration & dosage
Humans
*Immunotherapy
Interferon Type I, Recombinant/administration & dosage
Interleukin-2/administration & dosage
Kidney Neoplasms/blood/*immunology/*therapy
Leukocyte Count
*Lymphocyte Count
Male
Middle Aged
Prognosis
Survival Rate

Figure

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  Fig. 1 Changes in the blood total lymphocyte counts in the first month during immunotherapy.

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  Fig. 2 Changes in the blood total eosinophil counts in the first month during immunotherapy.

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  Fig. 3 Overall survival of the 40 patients with metastatic renal cell carcinoma treated with immunotherapy.

• 

  Fig. 4 Survival curves by blood total lymphocyte counts at week 4.

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