Low absolute peripheral blood CD4+ T-cell count predicts poor prognosis in R-CHOP-treated patients with diffuse large B-cell lymphoma

Abstract

The absolute peripheral blood lymphocyte count at diagnosis is known to be a strong prognostic factor in patients with diffuse large B-cell lymphoma (DLBCL) treated with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP), but it remains unclear as to which peripheral blood lymphocyte population is reflective of DLBCL prognosis. In this cohort, 355 patients with DLBCL treated with R-CHOP from 2006 to 2013 were analyzed. The low absolute CD4+ T-cell count (ACD4C) at diagnosis negatively correlated with the overall response rate and the complete response rate significantly (Po0.00001). An ACD4Co343 × 106/l had a significant negative impact on the 5-year progression-free survival and the overall survival as compared with an ACD4C ⩾ 343 × 106/l (73.7% (95% confidence interval (CI) = 66.7–79.5) versus 50.3% (95% CI = 39.0–60.6), Po0.00001 and 83.3% (95% CI = 77.1–88.0) versus 59.0% (95% CI = 47.9–68.5), Po0.00000001, respectively). Multivariate analysis revealed that the ACD4C was an independent prognostic marker (hazard ratio = 2.2 (95% CI = 1.3–3.7), Po0.01). In conclusion, a low ACD4C at diagnosis served as an independent poor prognostic marker in patients with DLBCL.