Early Lymphocyte Recovery and Sarcomas: An Extensively Available and Potentially Useful Biomarker as a Good Prognosis Factor

  1. E.J. Bardón-Cancho 2
  2. A. Sobrino Baladrón 1
  3. J. Orcajo-Rincón 3
  4. C. Huerta-Aragonés 4
  5. C. Garrido-Colino 4
  6. C. Mata-Fernández 4
  1. 1 Hospital General Universitario Gregorio Marañón, Servicio de Cardiología Infantil, Madrid, Spain
  2. 2 Hospital General Universitario Gergorio Marañón, Sección de Hematología y Oncología Pediátricas, Madrid, Spain
  3. 3 Hospital General Universitario Gregorio Marañón, Servicio de Medicina Nuclear, Madrid, Spain
  4. 4 Hospital General Universitario Gregorio Marañón, Sección de Hematología y Oncología Pediátricas, Madrid, Spain
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Actas:
51st Congress of the International Society of Paediatric Oncology (SIOP)

Editorial: Wiley

ISSN: 1545-5009,  1545-5017

Año de publicación: 2019

Volumen: 66

Número: Supl 4

Páginas: 1

Congreso: 51st Congress of the International Society of Paediatric Oncology (SIOP) Lyon, France, October 23–26, 2019

Tipo: Aportación congreso

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Resumen

Background/Objectives: Several authors suggest that an early lymphocyte recovery (ELR) after the first cycle of chemotherapy (ChT) is a favorable prognostic factor in Ewing sarcoma (ES) and osteosarcoma in children. The aim of our study is to determine the association of absolute lymphocyte and neutrophil count (ALC and ANC) post-ChT with overall survival (OS) in children and adolescents with ES, osteosarcoma, rhabdomyosarcoma and non-rhabdomyosarcoma soft tissue sarcomas (NRSTS).Design/Methods: Retrospective unicentric and observational study in patients younger than 21 years with ES, osteosarcoma, rhabdomyosarcoma and NRSTS, histologically diagnosed between November 1999 and October 2019. Medical records were reviewed and demographic, clinical, analytical and survival data were collected, including ALC at diagnosis and ANC and ALC on day 14±1 post-ChT. Patients with immune pathology, post-transplant tumors, previous ChT or incomplete records were excluded. All patients were treated according to the current international protocols.Results: Forty-nine patients were included, with 12.79 years of median age at diagnosis. The diagnoses were: eighteen ES (36.7%), 12 osteosarcomas (24.5%), 12 rhabdomyosarcomas (24.5%) and 7 NRSTS (14.3%). Fifteen (30.6%) were metastatic at diagnosis. The 2-year OS and 5-year OS were 85.7% and 72.8%, respectively, without taking into account those patients who have not completed that follow-up time. In ES group, there is a trend towards statistical significance (p=0.051) with greater survival if ALC pre-ChT was ≥1400. In osteosarcoma group, there are statistically significant differences in survival in favor of patients with ANC-14 ≥ 1500. In rhabdomyosarcoma, there was a trend towards significance (p=0.065) with greater survival if ALC-14 was ≥1000, as well as in relapse probability if ALC-14 < 800 (p=0.053).Conclusions: In rhabdomyosarcoma, ELR (ALC ≥ 1000 in day +14 post-ChT) may act as a prognostic and potentially useful factor in the stratification of risk. Larger studies should be implemented for these sarcomas in order to verify these results.