A systematic review of the influence of radiation-induced lymphopenia on survival outcomes in solid tumors

Crit Rev Oncol Hematol. 2018 Mar:123:42-51. doi: 10.1016/j.critrevonc.2018.01.003. Epub 2018 Feb 2.

Abstract

Lymphopenia is a common accompaniment of multimodal cancer therapy. As the most radiosensitive cells of the hematopoietic system, lymphocytes residing within or circulating through a radiation portal are frequently depleted by radiation therapy. The recognition that radiation-induced reduction of circulating lymphocyte counts and eventual lymphocyte infiltration of tumors have a tangible impact on overall survival outcomes has revived the interest in understanding the causes of treatment-associated lymphopenia and developing strategies to predict, prevent and ameliorate this well-documented phenomenon. In this systematic review, we have performed a comprehensive search of the literature to elucidate the studies that document a correlation between radiation-associated lymphopenia and survival outcomes in solid malignancies. We also summarize potential unifying paradigms that account for radiation-induced lymphopenia across studies and lay the groundwork for attempting to explain and/or counter this phenomenon.

Keywords: Chemotherapy; Lymphopenia; Radiation; Systematic review.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Humans
  • Lymphocyte Count
  • Lymphopenia / diagnosis*
  • Lymphopenia / etiology
  • Lymphopenia / mortality*
  • Neoplasms / complications
  • Neoplasms / diagnosis*
  • Neoplasms / mortality*
  • Neoplasms / radiotherapy*
  • Prognosis
  • Radiation Injuries / diagnosis*
  • Radiation Injuries / mortality*
  • Survival Analysis
  • Treatment Outcome