The Ratio of the Absolute Lymphocyte Count to the Absolute Monocyte Count Is Associated with Prognosis in Hodgkin's Lymphoma: Correlation with Tumor-Associated Macrophages

Koh, Young Wha; Kang, Hyo Jeong; Park, Chan-Sik; Yoon, Dok Hyun; Kim, Shin; Suh, Cheolwon; Go, Heounjeong; Kim, Ji Eun; Kim, Chulwoo; Huh, Jooryung

doi:10.1634/theoncologist.2012-0034

Cited by 112 publications

(111 citation statements)

References 38 publications

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“…10 Recently, elevated peripheral blood monocyte counts at diagnosis have been shown to be an independent marker associated with poor prognosis in patients with both non-Hodgkin and Hodgkin lymphoma. In this study, we retrospectively analyzed the data from a total of 550 patients with diffuse large B-cell lymphoma and evaluated the relationship between central nervous system relapse and absolute monocyte counts at diagnosis.…”

Section: Discussionmentioning

confidence: 99%

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Absolute peripheral monocyte count at diagnosis predicts central nervous system relapse in diffuse large B-cell lymphoma

et al. 2014

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ABSTRACTnation of blood smears in cases in which the automated counts were abnormal.CNS relapse-free survival was calculated by cause-specific function, censoring patients who died without CNS relapse, in accordance with previously published studies.11-14 The starting date of the time-to-event analysis was defined at diagnosis. Univariate and multivariate analyses of estimated risk factors for CNS relapse in DLBCL patients were performed using the log-rank test and Cox proportional hazard regression analysis. P values <0.05 were considered statistically significant. Background characteristics of the patients with and without CNS involvement were compared using the Fisher exact test and Student t-test. All statistical analyses were performed with EZR 15 (Saitama, Medical Center, Jichi Medical University, Japan).

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Section: Discussionmentioning

confidence: 99%

“…Recently, elevated peripheral blood monocyte counts have been shown to be an independent predictor of poor prognosis in patients with both non-Hodgkin and Hodgkin lymphoma. [5][6][7][8][9][10] Here, we investigated the relationship between peripheral blood monocytes at diagnosis and prognosis, focusing on CNS relapse in DLBCL.…”

Section: Introductionmentioning

confidence: 99%

Absolute peripheral monocyte count at diagnosis predicts central nervous system relapse in diffuse large B-cell lymphoma

et al. 2014

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“…Severe lymphocytopenia-defined either as lymphocytes ,8% or as an ALC of ,0.6 3 10 9 /L-is one of the seven independent factors of IPS for advanced HL [1]. The increased number of tumor-associated macrophages (TAMs) in histologic sections is a novel, well-established biological marker associated with poor prognosis [6], which has been positively correlated with the percentage of blood monocytes [7].…”

Section: Introductionmentioning

confidence: 99%

“…Indeed, 141 of 476 patients with an ALC/AMC ratio ,1.1 had a markedly inferior outcome compared with those with ratios $1.1 [8]. Koh et al also investigated the role of ALC/AMC in HL and found a much weaker relationship with prognosis in an analysis of 312 patients, using 2.9 as optimal cutoff [7]. Two subsequent studies provided contradictory results, using variable cutoffs [9,10].…”

Section: Introductionmentioning

confidence: 99%

Prognostic Implication of the Absolute Lymphocyte to Absolute Monocyte Count Ratio in Patients With Classical Hodgkin Lymphoma Treated With Doxorubicin, Bleomycin, Vinblastine, and Dacarbazine or Equivalent Regimens

et al. 2016

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Low absolute lymphocyte count (ALC) to absolute monocyte count (AMC) ratio (ALC/AMC) is an independent prognostic factor in Hodgkin lymphoma (HL), but different cutoffs (1.1, 1.5, and 2.9) have been applied. We aimed to validate the prognostic significance of ALC/AMC in 537 homogenously treated (doxorubicin, bleomycin, vinblastine, and dacarbazine or equivalents ± radiotherapy) classical HL patients at various cutoffs. The median ALC/AMC was 2.24 (0.44–20.50). The median AMC was 0.653 × 109/L (0.050–2.070). Lower ALC/AMC was associated with established markers of adverse prognosis. In total, 477 (89%), 418 (78%), and 189 (35%) patients had an ALC/AMC ratio of ≥1.1, ≥1.5, and ≥2.9; respectively; 20% had monocytosis (≥0.9 × 109/L). Ten-year time to progression (TTP) was 77% versus 55% for patients with ALC/AMC ≥1.1 and <1.1 (p = .0002), 76% versus 68% for ALC/AMC ≥1.5 and <1.5 (p = .049), 77% versus 73% for ALC/AMC ≥2.9 and <2.9 (p = .35), and 79% versus 70% for ALC/AMC ≥2.24 and <2.24 (p = .08), respectively. In stages ΙΑ/ΙΙΑ and in patients ≥60 years old, ALC/AMC had no significant effect on TTP. In advanced stages, ALC/AMC was significant only at the cutoff of 1.1 (10-year TTP 67% vs. 48%; p = .016). In younger, advanced-stage patients, the differences were more pronounced. In multivariate analysis of TTP, ALC/AMC < 1.1 (p = .007) and stage IV (p < .001) were independent prognostic factors; ALC/AMC was independent of International Prognostic Score in another model. ALC/AMC was more predictive of overall survival than TTP. At the cutoff of 1.1, ALC/AMC had independent prognostic value in multivariate analysis. However, the prognostically inferior group comprised only 11% of patients. Further research is needed prior to the widespread use of this promising marker.

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“…The peripheral blood absolute lymphocyte/monocyte ratio at diagnosis (ALC/AMC-DX), as a surrogate biomarker of host immunity (i.e., ALC) and tumor microenvironment (i.e., AMC), has been recently reported to be a predictor for overall survival, lymphoma-specific survival, progression-free survival, and time to progression in classical Hodgkin lymphoma (cHL) [1,2]. Interim PositronEmission Tomography (int-PET), as a functional imaging test for tumor activity, has been shown to be a predictor for progression-free survival (PFS) and time to progression (TTP) in cHL [3].…”

Section: Introductionmentioning

confidence: 99%

Absolute Lymphocyte/Monocyte Ratio at Diagnosis and Interim Positron-Emission Tomography Predict Survival in Classical Hodgkin Lymphoma

Porrata¹,

Ristow²,

Habermann³

et al. 2013

JCT

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Interim Positron-Emission Tomography (int-PET) and the peripheral blood absolute lymphocyte/monocyte ratio at diagnosis (ALC/AMC-DX) have been shown to be predictors for progression-free survival (PFS) and time to progression (TTP) in classical Hodgkin lymphoma (cHL). Therefore, we studied if the combination of ALC/AMC-DX and the (int-PET) can further stratified PFS and TTP in cHL patients. Patients were required to be diagnosed, treated, and followed with int-PET at Mayo Clinic, Rochester, Minnesota. From 2000 until 2008, 111 cHL patients qualified for the study. The median follow-up was 2.8 years (range: 0.3 -10.4 years). Patients with a negative int-PET (N = 98) presented with a higher ALC/AMC-DX (median of 2.32, range: 0.26 -37.5) compared with patients with a positive int-PET (N = 13) (median of 0.9, range: 0.29 -3.10), p < 0.004. By multivariate analysis, ALC/AMC-DX and the int-PET were independent predictors for PFS and TTP, when compared with the International prognostic Score. Patients were stratified into four groups: group 1 included patients with a negative int-PET and ALC/AMC-DX ≥ 1.1; group 2 included positive int-PET and ALC/AMC-DX ≥ 1.1; group 3 included negative int-PET and ALC/AMC-DX < 1.1; and group 4 included positive int-PET and ALC/AMC-DX < 1.1. Group 1 experienced superior PFS and TTP in comparison with the other groups. In conclusion, the combination of ALC/AMC-DX and the int-PET provides a simple model to assess clinical outcomes in cHL.

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The Ratio of the Absolute Lymphocyte Count to the Absolute Monocyte Count Is Associated with Prognosis in Hodgkin's Lymphoma: Correlation with Tumor-Associated Macrophages

Cited by 112 publications

References 38 publications

Absolute peripheral monocyte count at diagnosis predicts central nervous system relapse in diffuse large B-cell lymphoma

Absolute peripheral monocyte count at diagnosis predicts central nervous system relapse in diffuse large B-cell lymphoma

Prognostic Implication of the Absolute Lymphocyte to Absolute Monocyte Count Ratio in Patients With Classical Hodgkin Lymphoma Treated With Doxorubicin, Bleomycin, Vinblastine, and Dacarbazine or Equivalent Regimens

Absolute Lymphocyte/Monocyte Ratio at Diagnosis and Interim Positron-Emission Tomography Predict Survival in Classical Hodgkin Lymphoma

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