The prognostic role of neutropenia might be explained in multiple ways: firstly, systemic inflammation actively supports tumour initiation, promotion and progression; secondly, myelosuppression in severe neutropenic patients might lead to a significant reduction of myeloid-derived suppressing cells (MDSCs), resulting in the suppression of CD4+ T cells action against late-stage malignancies22. This evidence concerns the gene CD4 and Decreased total neutrophil count.