Pre-treatment lymphopenia and indication of tumor-induced systemic immunosuppression in medulloblastoma

J Neurooncol. 2018 Feb;136(3):541-544. doi: 10.1007/s11060-017-2678-3. Epub 2017 Nov 16.

Abstract

The presence of tumor-induced systemic immune suppression, including lymphopenia, has been recognized in adult patients with glioblastoma for several decades, and pre-treatment neutrophil-to-lymphocyte count ratio (NLCR) is associated with inferior clinical outcome in patients with glioblastoma. Whether tumor-induced systemic immune suppression is also present in children with malignant brain tumors is not known. We performed a retrospective analysis of pretreatment neutrophil and lymphocyte counts in pediatric patients with medulloblastoma (MB) compared to a control group of children with posterior fossa pilocytic astrocytoma (PA). Compared to the control group, we observed statistically significantly lower absolute lymphocyte counts (ALCs) and higher NLCRs in the medulloblastoma group. Our findings suggest the presence of tumor-induced systemic immune suppression in MB patients already present at the time of diagnosis, with potential implications for the development of immune therapies in this population.

Keywords: Lymphopenia; Medulloblastoma; Neutrophil/lymphocyte count ratio; Tumor-induced systemic immunosuppression.

MeSH terms

  • Adolescent
  • Cerebellar Neoplasms / blood*
  • Cerebellar Neoplasms / immunology*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Immune Tolerance*
  • Infant
  • Lymphocyte Count
  • Lymphopenia / immunology*
  • Male
  • Medulloblastoma / blood*
  • Medulloblastoma / immunology*
  • Retrospective Studies