NorthWest Biotherapeutics Inc (NWBO)

[Lykiri]

There were 170 patients with <800 and 161 with >800 ALC in the trial.

Meirluc,

You are confused. Doc logic means the inclusion criteria (Determined at pre-screening).

The trial's inclusion criteria demanded an Absolute Lymphocyte Count of ≥1,000/mm3.

Patients must have adequate bone marrow function (e.g., hemoglobin >10 g/dl, white blood count 3600-11,000mm3, absolute granulocyte count ≥1,500/mm3, absolute lymphocyte count ≥1,000/mm3, and platelet count ≥100K/mm3. Eligibility level of hemoglobin can be reached by transfusion.

https://clinicaltrials.gov/ct2/show/NCT00045968?cond=DCVax-L&draw=2&rank=3

So it's very ODD as well as adds more RISK to the trial that Germany would allow in ALC at half the count required elsewhere ≥500/mm3.

Determined at pre-leukapheresis visit
• Patients must have adequate bone marrow function prior to each leukapheresis procedure (hemoglobin >10 g/dl or >100g/L, white blood count ≥ 3.6x10E3/mm3 or ≥ 3.6x10E9/L, absolute granulocyte count ≥1.5x10E3/mm3 or ≥1.5x10E9/L, absolute lymphocyte count ≥0.5x10E3/mm3 or ≥0.5x10E9/L, and platelet count ≥100x10E3/mm3 or ≥100x10E9/L).

https://www.clinicaltrialsregister.eu/ctr-search/trial/2011-001977-13/DE

You refer to the ALC values after chemoradiation.

Absolute lymphocyte count (ALC) was?>?800 cells/mm3 in 48.6% of the patients (n?=?161) and was?<?800 cells/mm3 in 51.4% of patients (n?=?170), a characteristic that has been associated with poor prognosis after radiation.
https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-018-1507-6

Abstract
Background: The immune system plays an important role in cancer surveillance and therapy. Chemoradiation can cause severe treatment-related lymphopenia (TRL) (<500 cells/mm3) that is associated with reduced survival. Materials and Methods: Data from 4 independent solid tumor studies on serial lymphocyte counts, prognostic factors, treatment, and survival were collected and analyzed. The data set included 297 patients with newly diagnosed malignant glioma (N=96), resected pancreatic cancer (N=53), unresectable pancreatic cancer (N=101), and non–small cell lung cancer (N=47). Results: Pretreatment lymphocyte counts were normal in 83% of the patient population, and no patient had severe baseline lymphopenia. Two months after initiating chemoradiation, 43% developed severe and persistent lymphopenia (P=.001). An increased risk for death was attributable to TRL in each cancer cohort (gliomas: hazard rate [HR], 1.8; 95% CI, 1.13–2.87; resected pancreas: HR, 2.2; 95% CI, 1.17–4.12; unresected pancreas: HR, 2.9; 95% CI, 1.53–5.42; and lung: HR, 1.7; 95% CI, 0.8–3.61) and in the entire study population regardless of pathologic findings (HR, 2.1; 95% CI, 1.54–2.78; P<.0001). Severe TRL was observed in more than 40% of patients 2 months after initiating chemoradiation, regardless of histology or chemotherapy regimen, and was independently associated with shorter survival from tumor progression. Conclusions: Increased attention and research should be focused on the cause, prevention, and reversal of this unintended consequence of cancer treatment that seems to be related to survival in patients with solid tumors.
https://jnccn.org/view/journals/jnccn/13/10/article-p1225.xml