Abstract Details

Title Correlation Analysis of Lymphocyte and CD 4 Counts in Glioblastoma: Insight into Immunosuppression and Pneumocystis jiroveci pneumonia (PJP) Prophylaxis in Viral Gene Therapy and Standard of Care (SOC) – A Single Center Study

Topic Neuro-oncology

Presentation(s) P12 - Poster Session 12 (11:45 AM-12:45 PM)

Poster/Presentation
Number 6-015

Objective To assess whether absolute lymphocyte counts (ALC) correlate with CD4 cell counts in patients with glioblastoma at risk of immunosuppression and requiring PJP prophylaxis.

Background Chemoradiation is the standard of care (SOC) for glioblastoma, but only a subset of patients on temozolomide require PJP prophylaxis. Grossman et al. demonstrated that CD4 cell counts can predict risk for opportunistic infections, while others have proposed absolute lymphocyte count (ALC) as an alternative. Our study underscores the value of both CD4 and ALC in guiding prophylaxis decisions for patients receiving SOC and viral gene therapy.

Design/Methods

A retrospective review was conducted on glioblastoma patients enrolled in viral gene therapy (NCT 03603405). The study was approved by the Institutional Review Board (IRB). Descriptive statistics, Mann-Whitney U tests, Chi-squared tests, Spearman's coefficient, and Pearson's coefficient were used for statistical analysis. The statistical analyses were performed using R Studio version 2024.04.2+764.

Results

The study included 54 patients (37 male, 17 female) with a mean age of 60.09 years. At baseline, the mean CD4 count was 595.7 and ALC was 988.5. The mean ALC was stratified by CD4 count (< 200 vs >200) at baseline (535 vs 1024), follow-up at 2 months (366 vs 728), and final follow-up (482 vs 999). The correlation between ALC and CD4 counts in patients without opportunistic infections was R = 0.03, while in immunosuppressed patients, the correlation was R = 0.83 (on PJP prophylaxis) and 0.79 (not on PJP prophylaxis).

Conclusions

A strong correlation between ALC and CD4 counts was observed in patients with opportunistic infections, but not in non-immunosuppressed patients. Patients with lower CD4 counts tended to have lower ALC, although this difference was not statistically significant. Increasing sample size may establish stronger association that could lead to utilising ALC as a marker for immunosuppression risk assessment.

Authors/Disclosures
Jorge Akira Valdivia Moriyama, MD (The Houston Methodist Hospital) PRESENTER	Dr. Valdivia Moriyama has nothing to disclose.
Anza Zahid, MD, MBBS (Houston Methodist Hospital)	Dr. Zahid has nothing to disclose.
Sanjiti Mirmire, MBBS (Houston Methodist Hospital - Stanley H Appel Department of Neurology)	Dr. Mirmire has nothing to disclose.
Jemynna H. Chua, MD (Houston Methodist Hospital)	Dr. Chua has nothing to disclose.
Ashwin Achuthaprasad, MD	Dr. Achuthaprasad has nothing to disclose.
Ivo W. Tremont, MD, FAAN (AdventHealth)	Dr. Tremont has nothing to disclose.

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