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BMC Cancer
Published in: BMC Cancer 1/2022

Open Access 01-12-2022 | NSCLC | Research

Prognostic value of CD4+ T lymphopenia in non-small cell lung Cancer

Authors: Guillaume Eberst, Dewi Vernerey, Caroline Laheurte, Aurélia Meurisse, Vincent Kaulek, Laurie Cuche, Pascale Jacoulet, Hamadi Almotlak, Jean Lahourcade, Marie Gainet-Brun, Elizabeth Fabre, Françoise Le Pimpec-Barthes, Olivier Adotevi, Virginie Westeel

Published in: BMC Cancer | Issue 1/2022

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Abstract

Background

There is a paucity of data regarding the prognostic influence of peripheral blood CD4+ T lymphopenia in non-small cell lung cancer (NSCLC). Therefore, we investigated the prognostic value of T lymphopenia in NSCLC.

Materials

Treatment-naive patients with a pathological diagnosis of NSCLC, at clinical stage I to IV were included in the prospective TELOCAP1 study. Lymphocytes count was evaluated in peripheral blood by flow cytometry. CD4+ and CD8+ T lymphopenia were defined as an absolute count of < 500/μL and < 224/μL respectively. The prognostic value of T lymphopenia was analyzed in the whole population, in local/loco-regional (stage I-IIIB) and in advanced (stage IV) NSCLC disease, using the Kaplan-Meier method and Cox regression models for survival curves and multivariate analysis, respectively.

Results

Between July 2010 and January 2014, 169 evaluable patients with clinical stage I to IV NSCLC were prospectively enrolled. The prevalence of CD4+ and CD8+ T lymphopenia was similar in the study population (around 29%). Patients with CD4+ T lymphopenia showed lower overall survival than those with CD4+ T lymphocytes count > 500/μL (median overall survival (OS) 16.1 versus 21.7 months, hazard ratio (HR): 1.616 [95% CI: 1.1–2.36], p = 0.012). This association with OS was especially marked in local/loco-regional NSCLC stages (median OS, 21.8 versus 72 months, respectively, HR: 1.88 [95% CI: 0.9–3.8], p = 0.035). Multivariate analysis confirmed the worse prognosis associated with CD4+ T lymphopenia in local/loco-regional NSCLC, but not in metastatic patients (HR 2.028 [95% CI = 1.065–3.817] p = 0.02). Restricted cubic spline analysis showed that patients with CD4+ T lymphocytes count ≤500/μL displayed a high risk of death regardless of NSCLC clinical stage. There was no obvious relationship between CD8+ T lymphopenia and clinical outcome.

Conclusion

We identified CD4+ T lymphopenia as an independent prognostic factor in local/loco-regional stages of NSCLC and CD4+ T lymphopenia is also associated with a high risk of death, regardless of NSCLC clinical stage.

Trial registration

EUDRACT: 2009-A00642–55.
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Metadata
Title
Prognostic value of CD4+ T lymphopenia in non-small cell lung Cancer
Authors
Guillaume Eberst
Dewi Vernerey
Caroline Laheurte
Aurélia Meurisse
Vincent Kaulek
Laurie Cuche
Pascale Jacoulet
Hamadi Almotlak
Jean Lahourcade
Marie Gainet-Brun
Elizabeth Fabre
Françoise Le Pimpec-Barthes
Olivier Adotevi
Virginie Westeel
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2022
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-022-09628-8

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