Furthermore, it was suggested that anemia may influence the treatment outcome, as it could correlate with tumor hypoxia which, in turn, could be associated with poor immunotherapy outcome.45, 46, 47 Increased neutrophil levels have been associated with decreased overall survival in patients treated with ipilimumab, while high lymphocyte counts upon anti-CTLA-4 blockade and higher levels of albumin following treatment with durvalumab have been associated with improved survival.34 This evidence concerns the gene CTLA4 and anemia (phenotype).