Peripheral blood lymphocyte percentage may predict chemotolerance and survival in patients with advanced pancreatic cancer. Association between adaptive immunity and nutritional state

Roberto Aquilani, Silvia Brugnatelli, Roberto Maestri, Federica Boschi, Beatrice Filippi, Lorenzo Perrone, Annalisa Barbieri, Daniela Buonocore, Maurizia Dossena, Manuela Verri

Research output: Contribution to journalArticlepeer-review

Abstract

Pancreatic Carcinoma (PC) cells have the ability to induce patient immunosuppression and to escape immunosurveillance. Low circulating lymphocytes are associated with an advanced stage of PC and reduced survival. Blood lymphocytes expressed as a percentage of Total White Blood Cells (L% TWBC) could predict chemotolerance (n of tolerated cycles), survival time and Body Weight (BW) more effectively than lymphocytes expressed as an absolute value (LAB > 1500 n/mm3) or lymphocytes >22%, which is the lowest limit of normal values in our laboratory. Forty-one patients with advanced PC, treated with chemotherapy, were selected for this observational retrospective study. Patients were evaluated at baseline (pre-chemotherapy), and at 6, 12 and 18 months, respec-tively, after diagnosis of PC. The study found L ≥ 29.7% to be a better predictor of survival (COX model, using age, sex, BW, serum creatinine, bilirubin and lymphocytes as covariates), chemotol-erance (r = +0.50, p = 0.001) and BW (r = +0.35, p = 0.027) than LAB > 1500 or L > 22%. BW did not significantly correlate with chemotolerance or survival. The preliminary results of this study suggest that L ≥ 29.7% is more effective than LAB > 1500 or L > 22% at predicting chemotolerance, survival time and nutritional status. A possible impact of nutritional status on chemotherapy and survival seems to be lymphocyte-mediated given the association between BW and L%. This study may serve as the basis for future research to explore whether nutritional interventions can improve lymphopenia, and if so, how this may be possible.

Original languageEnglish
Pages (from-to)3280-3296
Number of pages17
JournalCurrent Oncology
Volume28
Issue number5
DOIs
Publication statusPublished - 2021

Keywords

  • Advanced pancreatic cancer
  • Chemotolerance
  • Impaired adaptive immune response
  • Nutritional status
  • Survival

ASJC Scopus subject areas

  • Oncology

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