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Title: Lymphopenia at diagnosis predicts survival of patients with immunodeficiency-associated lymphoproliferative disorders
Authors: Watanabe, Mizuki
Kanda, Junya  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0002-6704-3633 (unconfirmed)
Hishizawa, Masakatsu
Nishikori, Momoko  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0003-4171-2162 (unconfirmed)
Kondo, Tadakazu
Yamashita, Kouhei
Takaori-Kondo, Akifumi
Author's alias: 渡邊, 瑞希
諫田, 淳也
菱澤, 方勝
錦織, 桃子
近藤, 忠一
山下, 浩平
髙折, 晃史
Keywords: Immunodeficiency-associated lymphoproliferative disorders
PTLD
Immune-suppressive patients
Lymphopenia
Issue Date: Jul-2020
Publisher: Springer Nature
Journal title: Annals of Hematology
Volume: 99
Start page: 1565
End page: 1573
Abstract: The number of patients who are administered immunosuppressive agents has been increasing. Accordingly, more patients face higher risks for developing immunodeficiency-associated lymphoproliferative disorders (LPD). Although immunodeficiency-associated LPD are distinct from other lymphoid neoplasms in terms of their immunocompromised backgrounds, little is known about the impact of lymphopenia at diagnosis on survival in patients with these LPD. Seventy-one immunodeficiency-associated LPD in Kyoto University Hospital (post-transplant LPD (PTLD), n = 26; other iatrogenic immunodeficiency-associated LPD, n = 45) were reviewed and analyzed. The median age at diagnosis was 63 years (range, 3–83). Diffuse large B cell lymphoma was the most common subtype (n = 33), followed by Hodgkin lymphoma (n = 12), B cell monomorphic LPD not specified (n = 11), and polymorphic LPD or early-phase diseases (n = 15). The median follow-up period for survivors was 2.5 years and overall survival (OS) and progression-free survival (PFS) at 2.5 years were 75% and 67%, respectively. Multivariate analysis showed that lymphopenia (≤ 800/μL) at diagnosis predicted inferior OS (HR, 3.72; P = 0.043) and PFS (HR, 3.82; P = 0.012). Serum albumin values also strongly affected OS (> 3.18 g/dL vs. ≤ 3.18 g/dL; HR, 0.21; P = 0.010) and PFS (HR, 0.26; P = 0.013). Lymphopenia at diagnosis is suggested to predict inferior OS and PFS in patients with immunodeficiency-associated LPDs. Immunocompromised status might affect disease progression in these distinct lymphoid neoplasms growing under immunocompromised backgrounds.
Rights: This is a post-peer-review, pre-copyedit version of an article published in Annals of Hematology. The final authenticated version is available online at: http://dx.doi.org/10.1007/s00277-020-04084-5.
The full-text file will be made open to the public on 20 May 2021 in accordance with publisher's 'Terms and Conditions for Self-Archiving'.
This is not the published version. Please cite only the published version. この論文は出版社版でありません。引用の際には出版社版をご確認ご利用ください。
URI: http://hdl.handle.net/2433/254630
DOI(Published Version): 10.1007/s00277-020-04084-5
PubMed ID: 32436013
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