| Summary: | Introduction: Glioblastoma is amongst the tumours that have the worst prognosis. Although absolute lymphocyte count (ALC) has been described as a prognostic marker in glioblastoma, its role is controversial. The aim of this study is to evaluate the prognostic impact of the ALC in glioblastoma before and during treatment. Methods: We retrospectively evaluated clinical and haematological data of all glioblastoma patients treated at Centro Hospitalar Universitário São João between 2016 and 2020. We analysed the association between the ALC at different time-points over the course of the disease and overall survival (OS) and progression-free survival (PFS). Univariate and multivariate analysis was performed. Results: 204 patients were analysed. The median OS was 19.00 months (95%CI 15.08-22.92). No association was observed between the pre-op ALC, pre-chemoradiation therapy ALC and survival data. ALC at first progression < 1.15x109/L was associated with a median OS of 20 months compared to 30.9 months in patients with ALC ≥ 1.15x109/L (HR 0.57, p=0.041). Pre-chemoradiation therapy NLR ≥4 had a HR of 1.56 (p = 0.021), which corresponded to a median OS of 16.5 months, compared to 26.3 months in patients with NLR < 4. Multivariate analysis revealed tumoral extension and increasing corticosteroids dose at progression as the only independent prognostic factors. Conclusions: In our study only a low ALC at first progression was predictive of worse overall survival. This highlights the differential impact on outcome of haematological biomarkers at different timepoints of the disease.
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