White Cell Count Predicts Kidney Disease Prognosis

The number of lymphocytes in the blood is a possible prognostic indicator for renal cell carcinoma (RCC).

The lymphocytes are one of the types of white blood cells that are routinely enumerated in clinical laboratories and the low counts may be indicative of a suppressed immune system.

Medical oncologists at the Fox Chase Cancer Center, (Philadelphia, PA, USA), evaluated data from more than 500 patients with the most common form of RCC, called clear cell RCC, who had their kidneys surgically removed at Fox Chase between 1994 and 2009. They found a clear relationship between low lymphocyte counts within three months prior to surgery and a poor prognosis.

The scientists found that lower lymphocyte levels were associated with a higher tumor grade, a higher pathologic tumor stage, the presence of distant metastases, and a higher classification of malignant tumors (TNM) stage, which is a combined indicator of tumor stage, spread to regional lymph nodes, and distant metastasis. They also found that low counts were associated with a lower overall survival rate, even when they accounted for patient age, tumor stage, and metastasis.

Sunil Saroha, MD medical oncology fellow at Fox Chase and lead author on the study, said, "There has been this need for looking at prognostic markers that are available prior to surgical procedures. It would be nice to know before the surgery if the tumor is going to be aggressive and how aggressive we need to be, with the goal of individualizing therapies." This simple test can really help identify patients at the outset who are at risk of very aggressive disease and who may not do well with current therapies.

Each year, kidney cancer is diagnosed in nearly 60,000 people in the US Many of these patients undergo surgery to remove the affected kidney, but this procedure can be risky for the elderly and those who have other health problems. Unfortunately, the prognosis of kidney cancer patients often cannot be determined until tumor samples are surgically removed and evaluated. For example, if a young RCC patient does not have a low lymphocyte count, and is otherwise healthy, a doctor may decide not to pursue the more aggressive therapies, such as surgery and chemotherapy. The study will be presented at the Annual Meeting of the American Society of Clinical Oncology on June 5, 2011 in Chicago (IL, USA).

Related Links:
Fox Chase Cancer Center