Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Haematologica. 2012 Feb;97(2):262-9. doi: 10.3324/haematol.2011.050138. Epub 2011 Oct 11.
Lymphopenia and tumor-associated macrophages are negative prognostic factors for survival in classical Hodgkin's lymphoma. We, therefore, studied whether the peripheral blood absolute lymphocyte count/absolute monocyte count ratio at diagnosis affects survival in classical Hodgkin's lymphoma.
We studied 476 consecutive patients with classical Hodgkin's lymphoma followed at the Mayo Clinic from 1974 to 2010. Receiver operating characteristic curves and area under the curve were used to determine cut-off values for the absolute lymphocyte count/absolute monocyte count ratio at diagnosis, while proportional hazards models were used to compare survival based on the absolute lymphocyte count/absolute monocyte count ratio at diagnosis.
The median follow-up period was 5.6 years (range, 0.1-33.7 years). An absolute lymphocyte count/absolute monocyte count ratio at diagnosis of 1.1 or more was the best cut-off value for survival with an area under the curve of 0.91 (95% confidence interval, 0.86 to 0.96), a sensitivity of 90% (95% confidence interval, 85% to 96%) and specificity of 79% (95% confidence interval, 73% to 88%). Absolute lymphocyte count/absolute monocyte count ratio at diagnosis was an independent prognostic factor for overall survival (hazard ratio, 0.18; 95% confidence interval, 0.08 to 0.38, P<0.0001); lymphoma-specific survival (hazard ratio, 0.10; 95% confidence interval, 0.04 to 0.25, P<0.0001); progression-free survival (hazard ratio, 0.35; 95% confidence interval, 0.18 to 0.66, P<0.002) and time to progression (hazard ratio, 0.27; 95% confidence interval, 0.17 to 0.57, P<0.0006).
The ratio of absolute lymphocyte count/absolute monocyte count at diagnosis is an independent prognostic factor for survival and provides a single biomarker to predict clinical outcomes in patients with classical Hodgkin's lymphoma.
淋巴细胞减少和肿瘤相关巨噬细胞是经典霍奇金淋巴瘤患者生存的负性预后因素。因此，我们研究了诊断时外周血绝对淋巴细胞计数/绝对单核细胞计数比值是否影响经典霍奇金淋巴瘤患者的生存。
我们研究了 1974 年至 2010 年在梅奥诊所随访的 476 例连续的经典霍奇金淋巴瘤患者。使用接收者操作特征曲线和曲线下面积来确定诊断时绝对淋巴细胞计数/绝对单核细胞计数比值的截断值，同时使用比例风险模型根据诊断时绝对淋巴细胞计数/绝对单核细胞计数比值比较生存情况。
中位随访时间为 5.6 年（范围，0.1-33.7 年）。诊断时绝对淋巴细胞计数/绝对单核细胞计数比值为 1.1 或更高是生存的最佳截断值，曲线下面积为 0.91（95%置信区间，0.86 至 0.96），敏感性为 90%（95%置信区间，85%至 96%），特异性为 79%（95%置信区间，73%至 88%）。诊断时绝对淋巴细胞计数/绝对单核细胞计数比值是总生存（危险比，0.18；95%置信区间，0.08 至 0.38，P<0.0001）、淋巴瘤特异性生存（危险比，0.10；95%置信区间，0.04 至 0.25，P<0.0001）、无进展生存（危险比，0.35；95%置信区间，0.18 至 0.66，P<0.002）和进展时间（危险比，0.27；95%置信区间，0.17 至 0.57，P<0.0006）的独立预后因素。
诊断时绝对淋巴细胞计数/绝对单核细胞计数比值是生存的独立预后因素，并为预测经典霍奇金淋巴瘤患者的临床结局提供了一个单一的生物标志物。
