P1-15-4 - Leucocytosis as a Prognostic Factor in Patients with Metastatic Non Small Cell Lung Carcinoma

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Background: Tumor-related leucocytosis is a paraneoplasic syndrome that is encountered occasionally in clinical course of patients with non small cell lung carcinoma (NSCLC).The aim of this study was to establish the correlation between leucocytosis and survival in moroccan patients with metastatic NSCLC.Methods: We retrospectively reviewed 207 cases of metastatic non small cell lung carcinoma diagnosed between January 2007 and December 2012 at the department of medical oncology, Hassan II University Hospital, Fez, Morocco. Complete blood counts were performed at the time of diagnosis and prior to treatment. Leucocytosis was defined as an absolute white blood cell count >10.000/mm3; with no evidence of infection. We used the Kaplan-Meier method and Cox model to estimate overall survival (OS) and progression free survival (PFS).Results: Median age was 57.8 years. 85.5% of patients were men. 57.5% (107) of patients had leucocytosis at diagnosis with a mean of 15820/mm3;. Leucocytosis was more frequently associated with poor performance status (2/4 on the ECOG scale) (p = 0.0001) and pleural effusion (p = 0.04). However, it was not correlated to age, body mass index, number of metastatic sites, bone metastasis, liver metastasis, hypercalcemia, anemia and hypoalbuminemia. 64.7% (134) of patients were treated with platinum based chemotherapy. The median duration of follow-up was 6.4 months (range: 1 - 29 months). On univariate analysis, Leucocytosis was significantly associated with shorter OS (mean: 5.7 vs 8.7 months, p = 0,005). The PFS was not significantly different (mean: 5 vs 5.3 months, p = 0.9). On multivariate analysis, leucocytosis was independent negative prognostic factor for OS.Conclusion: Our results suggest that leucocytosis is probably an indicator for poorer outcome in metastatic non small cell lung cancer. Prospective clinical trials are needed to confirm or deny the prognostic role of leucocytosis in this cancer.