Absolute Monocyte Count and Lymphocyte-Monocyte Ratio Predict Outcome in Nodular Sclerosis Hodgkin Lymphoma: Evaluation Based on Data From 1450 Patients

Tadmor, Tamar; Bari, Alessia; Marcheselli, Luigi; Sacchi, Stefano; Aviv, Ariel; Baldini, Luca; Gobbi, Paolo G.; Pozzi, Samantha; Ferri, Paola; Cox, Maria Christina; Cascavilla, Nicola; Iannitto, Emilio; Federico, Massimo; Polliack, Aaron

doi:10.1016/j.mayocp.2015.03.025

Cited by 36 publications

(43 citation statements)

References 35 publications

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“…There is a body of evidence showing that the tumor microenvironment, host immunity, and systemic inflammatory responses are critical for determining the clinical course and outcome of patients with tumors . Using lymphocytes and monocytes as surrogate markers of tumor microenvironment and inflammatory responses, more and more studies have found that elevated absolute monocyte count (AMC), decreased absolute lymphocyte count (ALC), and the absolute lymphocyte to absolute monocyte count ratio (LMR) are predictors of various solid tumors, such as breast carcinoma, ovarian cancer, clonal cancer, and lung cancer, and similar findings have also been demonstrated in diffuse large B‐cell lymphoma (DLBCL) and classical Hodgkin's lymphoma (cHL) . In addition, parameters such as neutrophil‐lymphocyte ratio (NLR) and platelet‐lymphocyte ratio (PLR) have also exhibited prognostic activity in recent studies, although there were conflicting results .…”

Section: Introductionmentioning

confidence: 82%

Complete Blood Count Score Model Integrating Reduced Lymphocyte-Monocyte Ratio, Elevated Neutrophil-Lymphocyte Ratio, and Elevated Platelet-Lymphocyte Ratio Predicts Inferior Clinical Outcomes in Adult T-Lymphoblastic Lymphoma

Feng

et al. 2019

The Oncologist

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Background T‐lymphoblastic lymphoma (T‐LBL) is a highly aggressive neoplasm of lymphoblasts of T‐cell origin. Although promising improvements have been recently achieved, one third of patients experience relapse or refractory T‐LBL. Therefore, optimal strategies for identifying high‐risk patients are urgently needed. Materials and Methods In the present study, 75 newly diagnosed adult patients (aged ≥15 years) with T‐LBL were identified and the predictive value of complete blood count (CBC) abnormalities, including lymphocyte‐monocyte ratio (LMR), neutrophil‐lymphocyte ratio (NLR), and platelet‐lymphocyte ratio (PLR) on clinical outcomes, was analyzed. Results Using the receiver operating characteristic curve to determine the best cutoff values based on survival, it was found that patients with T‐LBL with LMR ≤2.8, NLR ≥3.3, and PLR ≥200 had both inferior progression‐free survival (PFS) and inferior overall survival (OS), in which the differences were much more remarkable in the international prognostic index score 0–2 subgroup. In the multivariable analysis, NLR ≥3.3 together with age >40 years and central nervous system (CNS) involvement were identified to be independently associated with shortened PFS, whereas PLR ≥200 and CNS involvement were identified to be independent risk factors for OS. LMR, NLR, and PLR were integrated to generate a “CBC score” model, which well separated adult patients with T‐LBL into three risk groups, and the 3‐year OS was 84%, 53%, and 30% for low‐, intermediate‐, and high‐risk patients, respectively. Conclusion Overall, a “CBC score” model was initially promoted for stratification in adult patients with T‐LBL using simple, widely available, and easy to interpret parameters in the largest adult T‐LBL cohort to date. Implications for Practice Optimal strategies for identifying high‐risk patients with T‐lymphoblastic lymphoma (T‐LBL) are urgently needed. In the largest adult T‐LBL cohort to date, simple, inexpensive, widely available parameters were applied and revealed that patients with lymphocyte‐monocyte ratio (LMR) ≤2.8, neutrophil‐lymphocyte ratio (NLR) ≥3.3, and platelet‐lymphocyte ratio (PLR) ≥200 had both inferior progression‐free survival and inferior overall survival (OS), in which the differences were much more remarkable in the international prognostic index score 0–2 subgroup. LMR, NLR, and PLR were integrated to generate a “complete blood count score” model, in which the 3‐year OS was 84%, 53%, and 30% for low‐, intermediate‐, and high‐risk patients, respectively.

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Section: Introductionmentioning

confidence: 82%

Complete Blood Count Score Model Integrating Reduced Lymphocyte-Monocyte Ratio, Elevated Neutrophil-Lymphocyte Ratio, and Elevated Platelet-Lymphocyte Ratio Predicts Inferior Clinical Outcomes in Adult T-Lymphoblastic Lymphoma

Feng

et al. 2019

The Oncologist

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“…In HL, low ALC,1 high AMC,2 and low lymphocyte to monocyte ratios2, 7 are associated with a poor prognosis. However until now, only a few studies have analyzed the prognostic significance of ANC and NLR in patients with HL.…”

Section: Discussionmentioning

confidence: 99%

“…Several investigators have considered the absolute lymphocyte count (ALC)1 as an important biomarker of tumor infiltrating lymphocytes, reflecting host immunity status, while absolute monocyte count (AMC)2 serves as a surrogate biomarker of tumor‐associated macrophages within the tumor microenvironment, and the absolute neutrophil count (ANC)3 as a measure of the systemic inflammatory response to malignancy. Inflammation is regarded as a critical component of tumor progression, and it is evident that the tumor microenvironment, is largely coordinated by inflammatory cells, which play a central role in the neoplastic process, promoting, proliferation, survival, and migration of tumor cell via activation of signaling pathways 4, 5, 6.…”

Section: Introductionmentioning

confidence: 99%

Neutrophil‐lymphocyte ratio at diagnosis is an independent prognostic factor in patients with nodular sclerosis Hodgkin lymphoma: results of a large multicenter study involving 990 patients

Marcheselli

Bari

Tadmor

et al. 2016

Hematological Oncology

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Several studies have demonstrated the prognostic value of neutrophil‐lymphocyte ratio (NLR) in patients with solid tumors and non–Hodgkin lymphoma. In contrast, there is only sparse data on its prognostic role in patients with classical Hodgkin lymphoma (cHL). The aim of our study was to establish whether NLR could serve as an independent prognostic factor in a cohort of 990 patients with nodular sclerosis (NS)‐cHL. After analysis of the log hazard ratio (HR) as a function of NLR, we chose the value 6 as cutoff. Patients with NLR >6 had a worse progression‐free survival and overall survival compared to those with NLR ≤6; 84% vs 75% and 92% vs 88%, at 5 years, with an HR of 1.65 and 1.82, respectively. Multivariate analysis showed that the risk remained high with HR 1.44 and HR 1.54 in progression‐free survival and overall survival, respectively. In summary, our study shows that NLR is a robust and independent prognostic parameter in NS‐cHL, both in early and advanced disease. It is inexpensive and simple to apply. Thus, we conclude that NLR, possibly in combination with the international prognostic score and absolute monocyte count, is a useful guide for physicians treating NS‐cHL patients.

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“…Immunity and inflammatory response impact the tumour microenvironment and malignancy progression (Mantovani et al , ). Metabolic and inflammatory parameters of the peripheral blood, and ratios of the latter, correlate with outcome in lymphoma patients (Tadmor et al , ). There is evidence outlining the prognostic significance of inflammation‐based scores including the Glasgow prognostic score (GPS; integrating serum C‐reactive protein and albumin), platelet‐to‐lymphocyte ratio (PLR) and neutrophil‐to‐lymphocyte ratio (NLR).…”

Section: Progression‐free and Overall Survival In Univariate Analysismentioning

confidence: 99%

The Glasgow prognostic score at diagnosis is an independent predictor of survival in advanced stage classical Hodgkin lymphoma

et al. 2018

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Absolute Monocyte Count and Lymphocyte-Monocyte Ratio Predict Outcome in Nodular Sclerosis Hodgkin Lymphoma: Evaluation Based on Data From 1450 Patients

Abstract: This study confirms that AMC has prognostic value in cHL that is particularly significant in patients with NS subtype histology. This finding links the known impact of macrophages and monocytes in Hodgkin lymphoma with routine clinical practice.

Cited by 36 publications

References 35 publications

Complete Blood Count Score Model Integrating Reduced Lymphocyte-Monocyte Ratio, Elevated Neutrophil-Lymphocyte Ratio, and Elevated Platelet-Lymphocyte Ratio Predicts Inferior Clinical Outcomes in Adult T-Lymphoblastic Lymphoma

Complete Blood Count Score Model Integrating Reduced Lymphocyte-Monocyte Ratio, Elevated Neutrophil-Lymphocyte Ratio, and Elevated Platelet-Lymphocyte Ratio Predicts Inferior Clinical Outcomes in Adult T-Lymphoblastic Lymphoma

Neutrophil‐lymphocyte ratio at diagnosis is an independent prognostic factor in patients with nodular sclerosis Hodgkin lymphoma: results of a large multicenter study involving 990 patients

The Glasgow prognostic score at diagnosis is an independent predictor of survival in advanced stage classical Hodgkin lymphoma

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