--- title: "Higher lyphocyte count predict lower mortality: breast CA. | Sutter Health" description: "Higher peripheral lymphocyte counts predicted lower mortality from early-stage TNBC, suggesting that immune function may enhance the effectiveness of early tx." url: "https://www.sutterhealth.org/research/publications/higher-lyphocyte-count-predict-lower-mortality-breast-ca-1055312328" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Higher lyphocyte count predict lower mortality: breast CA. # Higher absolute lymphocyte counts predict lower mortality from early-stage triple-negative breast cancer. Afghahi A, Purington N, Han SS, Desai M, Pierson E, Mathur MB, Seto T, Thompson CA, Rigdon J, Telli ML, Badve SS, Curtis C, West RB, Horst K, Gomez SL, Ford JM, Sledge GW, & Kurian AW. _Clin Cancer Res. pii: clincanres.1323.2017. doi: 10.1158/1078-0432.CCR-17-1323. \[Epub ahead of print\]_ 2018-03-26 ## Abstract BACKGROUND: Tumor-infiltrating lymphocytes (TILs) in pre-treatment biopsies are associated with improved survival in triple-negative breast cancer (TNBC). We investigated whether higher peripheral lymphocyte counts are associated with lower breast cancer-specific mortality (BCM) and overall mortality (OM) in TNBC. METHODS: Data on treatments and diagnostic tests from electronic medical records of two healthcare systems were linked with demographic, clinical, pathologic, and mortality data from the California Cancer Registry. Multivariable regression models adjusted for age, race/ethnicity, socioeconomic status, cancer stage, grade, neoadjuvant/adjuvant chemotherapy use, radiotherapy use, and germline BRCA1/2 mutations were used to evaluate associations between absolute lymphocyte count (ALC), BCM and OM. For a subgroup with TILs data available, we explored the relationship between TILs and peripheral lymphocyte counts. RESULTS: 1,463 Stage I-III TNBC patients were diagnosed from 2000-2014; 1113 (76%) received neoadjuvant/adjuvant chemotherapy within one year of diagnosis. Of 759 patients with available ALC data, 481 (63.4%) were ever lymphopenic (minimum ALC <1.0 K/μL). On multivariable analysis, higher minimum ALC, but not absolute neutrophil count, predicted lower OM (hazard ratio \[HR\]: 0.23, 95% confidence interval \[CI\]: 0.16-0.35) and BCM (HR: 0.19, CI: 0.11-0.34). Five-year probability of BCM was 15% for patients who were ever lymphopenic versus 4% for those who were not. An exploratory analysis (N=70) showed a significant association between TILs and higher peripheral lymphocyte counts during neoadjuvant chemotherapy. CONCLUSION: Higher peripheral lymphocyte counts predicted lower mortality from early-stage, potentially curable TNBC, suggesting that immune function may enhance the effectiveness of early TNBC treatment. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/29581131) ## Research topics - [Breast Cancer](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Breast+Cancer%5C%22%22) - [All Cancer](https://www.sutterhealth.org/research-search-results?query=%22%5C%22All+Cancer%5C%22%22) - [Genetics](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Genetics%5C%22%22) - [Medical Informatics](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Medical+Informatics%5C%22%22) - [Women's Health](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Women%27s+Health%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Use of gene expression profiling and chemotherapy in early-stage breast cancer: a study of linked electronic medical records, cancer registry data, and genomic data across two health care systems.](https://www.sutterhealth.org/research/publications/gene-expression-profile-chemotx-breast-ca-1055312292) Afghahi A, Mathur M, Thompson CA, Mitani A, Rigdon J, Desai M, Yu PP, de Bruin MA, Seto T, Olson C, Kenkare P, Gomez SL, Das AK, Luft HS, Sledge GW Jr, Sing AP, Kurian AW. J Oncol Pract. pii: JOPR009803. \[Epub ahead of print\] 2016 May 24 - Publication ### [Does the diagnosis of breast or ovarian cancer trigger referral to genetic counseling?](https://www.sutterhealth.org/research/publications/breast-ovarian-cancer-dx-trigger-genetic-counseling-referral-1055312651) Powell CB, Littell R, Hoodfar E, Sinclair F, Pressman A. Int J Gynecol Cancer. 23(3):431-6. doi: 10.1097/IGC.0b013e318280f2b4. 2013 Mar 01 - Publication ### [Breast cancer chemoprevention in primary care - assessing readiness for change.](https://www.sutterhealth.org/research/publications/breast-cancer-chemoprevention-in-primary-care-1055312742) Wang H, Snyder CF, Larson S, Vogel V, Kirchner HL, Sun H, Yan X. 24(6):283-288. Qual Prim Care. 2016 Nov 01 - Publication ### [Linking electronic health records to better understand breast cancer patient pathways within and between two health systems.](https://www.sutterhealth.org/research/publications/link-ehrs-understand-breast-cancer-pathways-1055312796) Thompson CA, Kurian AW, Luft HS. eGEMs (Generating Evidence & Methods to improve patient outcomes). 3(1). 2015 Mar 01 - Publication ### [The use of clinical characteristics to help prevent morcellation of leiomyosarcoma: An analysis of 491 cases.](https://www.sutterhealth.org/research/publications/clin-chars-prev-morcelln-lms-1055312401) Chan JK, Gardner AB, Thompson CA, Kapp DS. Am J Obstet Gynecol. 213(6):873-4. doi: 10.1016/j.ajog.2015.07.040. Epub 2015 Jul 29. 2015 Dec 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/higher-lyphocyte-count-predict-lower-mortality-breast-ca-1055312328#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Higher lyphocyte count predict lower mortality: breast CA."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/higher-lyphocyte-count-predict-lower-mortality-breast-ca-1055312328#medicalscholarlyarticle","name":"Higher absolute lymphocyte counts predict lower mortality from early-stage triple-negative breast cancer.","headline":"Higher lyphocyte count predict lower mortality: breast CA.","abstract":"BACKGROUND: Tumor-infiltrating lymphocytes (TILs) in pre-treatment biopsies are associated with improved survival in triple-negative breast cancer (TNBC). We investigated whether higher peripheral lymphocyte counts are associated with lower breast cancer-specific mortality (BCM) and overall mortality (OM) in TNBC. METHODS: Data on treatments and diagnostic tests from electronic medical records of two healthcare systems were linked with demographic, clinical, pathologic, and mortality data from the California Cancer Registry. Multivariable regression models adjusted for age, race/ethnicity, socioeconomic status, cancer stage, grade, neoadjuvant/adjuvant chemotherapy use, radiotherapy use, and germline BRCA1/2 mutations were used to evaluate associations between absolute lymphocyte count (ALC), BCM and OM. For a subgroup with TILs data available, we explored the relationship between TILs and peripheral lymphocyte counts. RESULTS: 1,463 Stage I-III TNBC patients were diagnosed from 2000-2014; 1113 (76%) received neoadjuvant/adjuvant chemotherapy within one year of diagnosis. Of 759 patients with available ALC data, 481 (63.4%) were ever lymphopenic (minimum ALC \u003c1.0 K/μL). On multivariable analysis, higher minimum ALC, but not absolute neutrophil count, predicted lower OM (hazard ratio [HR]: 0.23, 95% confidence interval [CI]: 0.16-0.35) and BCM (HR: 0.19, CI: 0.11-0.34). Five-year probability of BCM was 15% for patients who were ever lymphopenic versus 4% for those who were not. An exploratory analysis (N=70) showed a significant association between TILs and higher peripheral lymphocyte counts during neoadjuvant chemotherapy. CONCLUSION: Higher peripheral lymphocyte counts predicted lower mortality from early-stage, potentially curable TNBC, suggesting that immune function may enhance the effectiveness of early TNBC treatment.","description":"Higher peripheral lymphocyte counts predicted lower mortality from early-stage TNBC, suggesting that immune function may enhance the effectiveness of early tx.","keywords":["Breast Cancer","All Cancer","Genetics","Medical Informatics","Women's Health"],"datePublished":"2018-03-26","url":"https://www.sutterhealth.org/research/publications/higher-lyphocyte-count-predict-lower-mortality-breast-ca-1055312328","inLanguage":"en-US","identifier":[{"@type":"PropertyValue","propertyID":"PMID","value":"29581131"},{"@type":"PropertyValue","propertyID":"DOI","value":"10.1158/1078-0432.CCR-17-1323"}],"sameAs":["https://pubmed.ncbi.nlm.nih.gov/29581131/","https://doi.org/10.1158/1078-0432.CCR-17-1323"],"isPartOf":{"@type":"Periodical","name":"Clin Cancer Res"},"author":[{"@type":"Person","name":"Afghahi A"},{"@type":"Person","name":"Purington N"},{"@type":"Person","name":"Han SS"},{"@type":"Person","name":"Desai M"},{"@type":"Person","name":"Pierson E"},{"@type":"Person","name":"Mathur MB"},{"@type":"Person","name":"Seto T"},{"@type":"Person","name":"Thompson CA"},{"@type":"Person","name":"Rigdon J"},{"@type":"Person","name":"Telli ML"},{"@type":"Person","name":"Badve SS"},{"@type":"Person","name":"Curtis C"},{"@type":"Person","name":"West RB"},{"@type":"Person","name":"Horst K"},{"@type":"Person","name":"Gomez SL"},{"@type":"Person","name":"Ford JM"},{"@type":"Person","name":"Sledge GW"},{"@type":"Person","name":"Kurian AW"}],"sourceOrganization":{"@type":"MedicalOrganization","name":"Palo Alto Medical Foundation Research Institute"},"about":[{"@type":"DefinedTerm","name":"Breast Cancer","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Breast+Cancer%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"All Cancer","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22All+Cancer%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Genetics","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Genetics%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Medical Informatics","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Medical+Informatics%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Women's Health","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Women%27s+Health%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/higher-lyphocyte-count-predict-lower-mortality-breast-ca-1055312328","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/higher-lyphocyte-count-predict-lower-mortality-breast-ca-1055312328#breadcrumblist"}}} ```