An evaluation of data from 516 people with the most common form of renal cell carcinoma (RCC) demonstrated a strong relationship between low lymphocyte counts within 3 months prior to surgery and a poor prognosis.

Sunil Saroha, MD—a medical oncology fellow at Fox Chase Cancer Center in Philadelphia, Pennsylvania—and colleagues undertook this project to test their hypothesis that a low peripheral blood absolute lymphocyte count (a likely index of poor systemic immunity) may be associated with aggressive features and inferior outcome in clear cell RCC.

“There has been this need for looking at prognostic markers that are available prior to surgical procedures,” explained Saroha in a statement announcing the findings, which were presented at the annual meeting of the American Society of Clinical Oncology (ASCO), held June 3-7, 2011, in Chicago, Illinois ( “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.”

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The researchers performed a retrospective analysis of preoperative blood cell counts in patients undergoing primary surgical resection for clear cell RCC at Fox Chase Cancer Center over a recent 15-year period. Lymphocyte levels below 1,300 μl were associated with a higher tumor grade, a higher pathologic tumor stage, the presence of distant metastases, a higher tumor/nodes/metastasis (TNM) stage, and inferior overall survival.

Although the researchers note that these studies should be explored further in prospective research studies, performing a simple lymphocyte count could factor into treatment decisions for persons with clear cell RCC.