Olivera Markovic1, Lazar Popovic2, Dragomir Marisavljevic3, Darjana Jovanovic2, Branka Filipovic3, Dejana Stanisavljevic4, Gorana Matovina-Brko2, Jelena Hajder5, Tatjana Matkovic5, Radmila Živkovic5, Natasa Stanisavljevic5, Milena Todorović6, Dragana Petrovic5, Biljana Mihaljevic6. 1. Clinical Hospital Center "Bezanijska Kosa", Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Serbia. Electronic address: dragano@ptt.rs. 2. Institute of Oncology, Sremska Kamenica, Serbia; Faculty of Medicine University of Novi Sad, Serbia. 3. Clinical Hospital Center "Bezanijska Kosa", Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Serbia. 4. Institute of Statistics, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Serbia. 5. Clinical Hospital Center "Bezanijska Kosa", Belgrade, Serbia. 6. Institute of Hematology, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Serbia.
Abstract
BACKGROUND: The combination of absolute lymphocyte count (ALC) and absolute monocyte count (AMC) at diagnosis has prognostic relevance in patients with diffuse large B cell lymphoma (DLBCL). AIMS: The present study was designed to investigate the prognostic significance of ALC and AMC and to determine whether ALC/AMC ratio or ALC/AMC prognostic score is better predictor of outcome in DLBCL. METHODS: We retrospectively analyzed the prognostic significance of ALC and AMC, ALC/AMC ratio and ALC/AMC prognostic score at diagnosis in 222 DLBCL patients treated with R-CHOP. RESULTS: ROC analysis showed that optimal cut-off values of AMC and ALC/AMC ratio with the best sensitivity and specificity were 0.59×10(9)/L and 2.8, respectively. Cut-off of ALC was determined according to the literature data (1×10(9)/L). Low ALC, high AMC, low ALC/AMC ratio and high ALC/AMC prognostic score were in significant association with lower rate of therapy response and survival. In contrast, these parameters were not in significant correlation with relapse rate. The patients with low ALC, "high" AMC, low ALC/AMC ratio and high ALC/AMC prognostic score at diagnosis had significantly shorter EFS and OS. In multivariate analysis all tested parameters (ALC, AMC, ALC/AMC prognostic score and ALC/AMC ratio) are independent risk factors along with "bulky" disease and IPI. CONCLUSION: All tested parameters (ALC, AMC, ALC/AMC score and ALC/AMC ratio) may be useful prognostic factors in DLBCL patients. ALC/AMC score has a slight advantage as it allows the classification of patients into three prognostic groups. Further studies are needed to determine which of these parameters has the highest predictive value.
BACKGROUND: The combination of absolute lymphocyte count (ALC) and absolute monocyte count (AMC) at diagnosis has prognostic relevance in patients with diffuse large B cell lymphoma (DLBCL). AIMS: The present study was designed to investigate the prognostic significance of ALC and AMC and to determine whether ALC/AMC ratio or ALC/AMC prognostic score is better predictor of outcome in DLBCL. METHODS: We retrospectively analyzed the prognostic significance of ALC and AMC, ALC/AMC ratio and ALC/AMC prognostic score at diagnosis in 222 DLBCL patients treated with R-CHOP. RESULTS: ROC analysis showed that optimal cut-off values of AMC and ALC/AMC ratio with the best sensitivity and specificity were 0.59×10(9)/L and 2.8, respectively. Cut-off of ALC was determined according to the literature data (1×10(9)/L). Low ALC, high AMC, low ALC/AMC ratio and high ALC/AMC prognostic score were in significant association with lower rate of therapy response and survival. In contrast, these parameters were not in significant correlation with relapse rate. The patients with low ALC, "high" AMC, low ALC/AMC ratio and high ALC/AMC prognostic score at diagnosis had significantly shorter EFS and OS. In multivariate analysis all tested parameters (ALC, AMC, ALC/AMC prognostic score and ALC/AMC ratio) are independent risk factors along with "bulky" disease and IPI. CONCLUSION: All tested parameters (ALC, AMC, ALC/AMC score and ALC/AMC ratio) may be useful prognostic factors in DLBCL patients. ALC/AMC score has a slight advantage as it allows the classification of patients into three prognostic groups. Further studies are needed to determine which of these parameters has the highest predictive value.
Authors: Luis F Porrata; David J Inwards; Stephen M Ansell; Ivana N Micallef; Patrick B Johnston; William J Hogan; Svetomir N Markovic Journal: J Hematol Oncol Date: 2015-07-03 Impact factor: 17.388
Authors: Vivek Naranbhai; Helen A Fletcher; Rachel Tanner; Matthew K O'Shea; Helen McShane; Benjamin P Fairfax; Julian C Knight; Adrian V S Hill Journal: EBioMedicine Date: 2015-11 Impact factor: 8.143