Circulating Low Absolute CD4+ T Cell Counts May Predict Poor Prognosis in Extranodal NK/T-Cell Lymphoma Patients Treating with Pegaspargase-Based Chemotherapy

Zhang, Yaping; Zhang, Run; Zhu, Huayuan; Wang, Li; Wu, Yu‐Jie; Liang, Jin‐Hua; Shi, Wenyu; Liu, Hong; Xu, Wei; Li, Jianyong

doi:10.4143/crt.2018.010

Cited by 9 publications

(11 citation statements)

References 27 publications

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“…Extranodal NK/T cell lymphoma (ENKTL) is a unique histopathologic subtype of non-Hodgkin’s lymphoma (NHL), characterized by vascular damage and destruction, necrosis, cytotoxic phenotype, and Epstein–Barr virus (EBV) infection [1]. ENKTL, rare in Europe and North America, is more prevalent in Asia and South America, making up about 5–16% of all NHL patients in China [2]. ENKTL is a highly heterogeneous malignant lymphoma.…”

Section: Introductionmentioning

confidence: 99%

“…Proinflammatory chemokines and cytokines in tumor microenvironments contribute to the proliferation and survival of malignant cells [6, 7]. Inflammatory indexes such as c-reactive protein (CRP), lymphocyte, and monocyte have been reported to have prognostic values in patients with ENKTL [8–10]. Lymphocyte is an important biomarker which reflects the host’s immune status, and lymphopenia is associated with a poorer survival in various subtypes of NHL, including ENKTL.…”

Section: Introductionmentioning

confidence: 99%

“…Lymphocyte is an important biomarker which reflects the host’s immune status, and lymphopenia is associated with a poorer survival in various subtypes of NHL, including ENKTL. Monocyte is thought to be surrogate markers of tumor microenvironments [8, 9]. These findings suggest that lymphocytes and monocytes are involved in anti-tumor immune response as well as formation of the tumor microenvironments.…”

Section: Introductionmentioning

confidence: 99%

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The predictive value of dynamic monitoring of peripheral blood lymphocyte to monocyte ratio in patients with extranodal NK/T cell lymphoma

Zhang

Yuan

et al. 2019

Cancer Cell Int

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BackgroundTo investigate the value of dynamic monitoring peripheral blood lymphocyte-to-monocyte (LMR) ratio in evaluating the treatment response and prognosis of patients with extranodal NK/T cell lymphoma (ENKTL).MethodsA total of 148 patients with ENKTL were retrospectively analyzed in the Affiliated Tumor Hospital of Zhengzhou University between March 2012 and March 2018. The optimal cut-off value of LMR was determined using the receiver operating characteristic curve (ROC) method, then patients were divided into low LMR group and high LMR group. The LMR level was dynamically measured at various time points, and the relationships between LMR and therapeutic response, and survival were analyzed.ResultsThe complete remission rate (CR) was 85.7% in patients with high LMR at diagnosis, which was remarkably higher than that of patients with low LMR at diagnosis (64.9%) (P = 0.009). The 5-year overall survival (OS) and progression-free survival (PFS) were 49.28% and 44.89% in the low LMR group, respectively; 5-year OS and PFS in the high LMR group were 84.50% and 67.12%, respectively, significantly longer (P values were < 0.001 and 0.034, respectively). The OS and PFS of patients with elevated LMR after treatment were longer than those with decreased LMR after treatment (all P values < 0.05). The LMRs at relapse were significantly lower in both high and low LMR groups than those of the last follow-up (P values were 0.001 and 0.016, respectively). Univariate and multivariate analysis demonstrated that low LMR was an independent risk factor for poor prognosis in ENKTL patients (P values were < 0.001 and 0.009, respectively).ConclusionsLymphocyte to monocyte ratio can be used as an indicator of treatment response, prognosis and recurrence in patients with ENKTL. Low LMR before and after treatment is a poor prognostic factor.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The predictive value of dynamic monitoring of peripheral blood lymphocyte to monocyte ratio in patients with extranodal NK/T cell lymphoma

Zhang

Yuan

et al. 2019

Cancer Cell Int

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“…Identifying the number of CD4+ T cells, CD8+ T cells, and the CD4+/CD8+ ratio in peripheral blood can thus represent the immunological state of patients with malignant tumors, and it may also be useful in predicting the prognosis of FL patients. The prognostic value of peripheral blood T-lymphocytes has also been reported in patients suffering from various subtypes of lymphoma (32,(40)(41)(42). However, no study has yet precisely reported the prognostic value of the T-cell subset in FL and its added value to clinical prognostic indices that identify patients especially at high risk of early death and progression even after the application of modern immunochemotherapy.…”

Section: Discussionmentioning

confidence: 99%

An Immune-Clinical Prognostic Index (ICPI) for Patients With De Novo Follicular Lymphoma Treated With R-CHOP/CHOP Chemotherapy

Gong

et al. 2021

Front. Oncol.

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PurposeAlthough the role of tumor-infiltrating T cells in follicular lymphoma (FL) has been reported previously, the prognostic value of peripheral blood T lymphocyte subsets has not been systematically assessed. Thus, we aim to incorporate T-cell subsets with clinical features to develop a predictive model of clinical outcome.MethodsWe retrospectively screened a total of 1,008 patients, including 252 newly diagnosed de novo FL patients with available peripheral blood T lymphocyte subsets who were randomized to different sets (177 in the training set and 75 in the internal validation set). A nomogram and a novel immune-clinical prognostic index (ICPI) were established according to multivariate Cox regression analysis for progression-free survival (PFS). The concordance index (C-index), Akaike’s information criterion (AIC), and likelihood ratio chi-square were employed to compare the ICPI’s discriminatory capability and homogeneity to that of FLIPI, FLIPI2, and PRIMA-PI. Additional external validation was performed using a dataset (n = 157) from other four centers.ResultsIn the training set, multivariate analysis identified five independent prognostic factors (Stage III/IV disease, elevated lactate dehydrogenase (LDH), Hb <120g/L, CD4+ <30.7% and CD8+ >36.6%) for PFS. A novel ICPI was established according to the number of risk factors and stratify patients into 3 risk groups: high, intermediate, and low-risk with 4-5, 2-3, 0-1 risk factors respectively. The hazard ratios for patients in the high and intermediate-risk groups than those in the low-risk were 27.640 and 2.758. The ICPI could stratify patients into different risk groups both in the training set (P < 0.0001), internal validation set (P = 0.0039) and external validation set (P = 0.04). Moreover, in patients treated with RCHOP-like therapy, the ICPI was also predictive (P < 0.0001). In comparison to FLIPI, FLIPI2, and PRIMA-PI (C-index, 0.613-0.647), the ICPI offered adequate discrimination capability with C-index values of 0.679. Additionally, it exhibits good performance based on the lowest AIC and highest likelihood ratio chi-square score.ConclusionsThe ICPI is a novel predictive model with improved prognostic performance for patients with de novo FL treated with R-CHOP/CHOP chemotherapy. It is capable to be used in routine practice and guides individualized precision therapy.

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“…Chronic in ammation has been demonstrated to be associated with tumor development and progression [11,12]. Absolute lymphocyte counts (ALCs) in the peripheral blood re ect the host immune status [13][14][15][16]. Absolute monocyte counts (AMCs) act as an indicator for tumor-associated macrophages [17,18].…”

Section: Introductionmentioning

confidence: 99%

The Predictive Value of the Peripheral Blood Lymphocyte-to-Monocyte Ratio in Patients with Anaplastic Large Cell Lymphoma

Zhang¹,

Chen²,

Wang³

et al. 2021

Preprint

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BackgroundTo assess the value of the peripheral blood lymphocyte-to-monocyte ratio (LMR) in predicting the early treatment response and prognosis in patients with anaplastic large cell lymphoma (ALCL).MethodsThe optimal cut-off value for the LMR was determined using the receiver operating characteristic curve (ROC) method. The LMR was monitored dynamically, and the relationship between the LMR and therapeutic response, and survival was analyzed.Results The cumulative complete remission (CCR) rate was 57.1% in patients with low baseline LMR, remarkably lower than that for patients with high baseline LMR (80.0%) (P = 0.019). The 5-year overall survival (OS) and progression-free survival (PFS) were 51.3% and 32.6%, respectively, in the low baseline LMR group, which were significantly poorer at 90.4% and 70.5% in the high baseline LMR group, respectively (P values were 0.006 and 0.013, respectively). Furthermore, the median OS and PFS of patients with a decreased LMR after treatment were shorter than those with an elevated LMR after treatment (all P values < 0.05). Univariate and multivariate analysis demonstrated that low baseline LMR is an independent indicator for poor prognosis in ALCL patients (P values were 0.006 and 0.020, respectively). Interestingly, the combination of low baseline LMR and ALK positive could strongly predict the good prognosis in patients with ALCL. ConclusionsThe low baseline LMR and a decreased LMR after treatment are prognostic indicator for poor PFS and OS. The combination of LMR and ALK expression can widely risk-stratify patients for treatment and survival in patients with ALCL.

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Circulating Low Absolute CD4+ T Cell Counts May Predict Poor Prognosis in Extranodal NK/T-Cell Lymphoma Patients Treating with Pegaspargase-Based Chemotherapy

Abstract: Low ACD4Cs were associated with poorer survival and could act as a negative predictor for ENKTL patients treated with asparaginase-based regimens.

Cited by 9 publications

References 27 publications

The predictive value of dynamic monitoring of peripheral blood lymphocyte to monocyte ratio in patients with extranodal NK/T cell lymphoma

The predictive value of dynamic monitoring of peripheral blood lymphocyte to monocyte ratio in patients with extranodal NK/T cell lymphoma

An Immune-Clinical Prognostic Index (ICPI) for Patients With De Novo Follicular Lymphoma Treated With R-CHOP/CHOP Chemotherapy

The Predictive Value of the Peripheral Blood Lymphocyte-to-Monocyte Ratio in Patients with Anaplastic Large Cell Lymphoma

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