The negative prognostic impact of low absolute CD4+ T cell counts in peripheral blood in mantle cell lymphoma

Abstact

Tumor microenvironment and host immunity are closely related to patients' outcomes with mantle cell lymphoma (MCL). However, few researches focused on prognostic value of peripheral blood lymphocyte subsets counts. The purpose of this study was to investigate the prognostic value of lymphocyte subsets and absolute monocyte counts (AMC). Sixty-eight patients were analyzed retrospectively. Level of absolute CD4⁺ T cell counts (ACD4C), CD8⁺ T cell counts (ACD8C), nature killer cell counts (ANKC) and CD4/CD8 ratio were assessed by peripheral blood flow cytometry (PBFCM) and correlated with clinical parameters and long-term outcomes. The median follow-up for all patients was 21 months and the median survival time was 44 months. The overall survival (OS) rate at 1, 3 and 5 years was 80%, 51% and 41%, respectively. In our cohort, high AMC, and low ACD4C and CD4/CD8 ratio were associated with unfavorable OS (P=0.029, P=0.027 and P=0.045, respectively) by univariate analysis. Multivariate analysis indicate that low ACD4C was significant predictor of unfavorable OS (P=0.004) independent of sMIPI (P=0.048) in patients treated with or without rituximab (P=0.011). Conclusion: Low CD4⁺ T cell counts proved to be a significant predictor of unfavorable OS in patients with MCL.

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