A recent study sheds light on the potential role of lymphopenia in predicting outcomes for multiple myeloma (MM) patients. Conducted primarily within Veterans Administration (VA) hospitals, the study involved 11,427 patients, predominantly male due to the VA system's demographic. Researchers found that lymphopenia, present in 53% of patients at diagnosis, is linked with inferior overall survival rates. The study holds significant implications for the treatment and management of MM.
Led by Grace M. Ferri and Cenk Yildirim from Boston Medical Center, the research stratified patients into three categories based on their absolute lymphocyte count: severely low, low, and normal. These categories were defined as less than 1 × 10⁹/μL, between 1 × 10⁹/μL to 1.5 × 10⁹/μL, and greater than 1.5 × 10⁹/μL, respectively. The study revealed a stark contrast in median overall survival rates: 2.7 years for those with severely low counts compared to 4.2 years for those with normal counts.
“Because immune dysregulation and immunosenescence in the bone marrow microenvironment are reflected in the peripheral blood lymphocyte count and peripheral blood markers may, in turn, correlate with clinical features and outcome in MM, we sought to identify clinical features correlating with peripheral blood lymphopenia and evaluate absolute lymphocyte count at diagnosis as a predictor of outcome in MM and in the context of standard induction treatment,” said the authors.
The study also highlighted that standard induction therapy using lenalidomide, bortezomib, and dexamethasone did not ameliorate the inferior outcomes associated with lymphopenia. Despite this regimen's effectiveness in many cases, patients with severely low absolute lymphocyte counts had a median survival of only 3.6 years compared to 5.7 years for those with normal counts.
Exclusions from the study included patients with acute and chronic leukemias, aplastic anemia, myelodysplastic syndrome, hairy cell leukemia, or myeloproliferative neoplasms prior to their MM diagnosis. The follow-up period extended from diagnosis until the development of another hematologic malignancy, patient death, or up to 15 years post-diagnosis.
Published online on December 27 in Blood Advances, the study offers valuable insights for healthcare professionals dealing with MM. Individual-level data from this research is available to approved researchers under Veterans Affairs policy, providing a resource for further investigation into MM treatment outcomes.
Leave a Reply