Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Br J Haematol. 2012 May;157(3):321-30. doi: 10.1111/j.1365-2141.2012.09067.x. Epub 2012 Feb 24.
The pathological background in nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) consists of lymphocytes and histocytes. This study analysed the peripheral blood absolute lymphocyte count/absolute monocyte count ratio at diagnosis (ALC/AMC-DX) on the impact of survival in NLPHL. One hundred and three consecutive NLPHL patients that were followed at Mayo Clinic from 1974 to 2010 were included in the study. Receiver operating characteristic and area under the curve were used for ALC/AMC-DX cut-off value analysis and proportional-hazards models were used to compare survival based on the ALC/AMC-DX ratio. With a median follow-up of 8·9 years (range: 0·3-31 years), an ALC/AMC-DX ≥2·1 was the best cut-off value for survival with an area under the curve of 0·82, a sensitivity of 70% and specificity of 84%. After adjusting for the International Prognostic Score (IPS), ALC/AMC-DX remained an independent prognostic factor for overall survival [Hazard Ratio (HR), 0·33, 95% confidence interval (CI), 0·15-0·71%, P < 0·004]; lymphoma-specific survival (HR, 0·05; 95%CI, 0·01-0·68%, P < 0·002); progression-free survival (HR, 0·30; 95%CI, 0·14-0·60%, P < 0·006), and time to progression (HR, 0·06, 95%CI, 0·04-0·30%, P < 0·004). ALC/AMC-DX is a low cost, already standarized, biomarker to predict clinical outcomes in NLPHL.
结节性淋巴细胞为主型霍奇金淋巴瘤（NLPHL）的病理背景由淋巴细胞和组织细胞组成。本研究分析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（ALC/AMC-DX）对 NLPHL 患者生存的影响。共纳入 103 例连续的 NLPHL 患者，他们于 1974 年至 2010 年在梅奥诊所接受随访。采用接收者工作特征曲线和曲线下面积分析 ALC/AMC-DX 截断值，采用比例风险模型比较基于 ALC/AMC-DX 比值的生存情况。中位随访 8.9 年（范围：0.3-31 年），ALC/AMC-DX≥2.1 为生存的最佳截断值，曲线下面积为 0.82，灵敏度为 70%，特异性为 84%。在校正国际预后评分（IPS）后，ALC/AMC-DX 仍然是总生存的独立预后因素[风险比（HR）0.33，95%置信区间（CI）0.15-0.71%，P<0.004]；淋巴瘤特异性生存（HR，0.05；95%CI，0.01-0.68%，P<0.002）；无进展生存（HR，0.30；95%CI，0.14-0.60%，P<0.006）和进展时间（HR，0.06，95%CI，0.04-0.30%，P<0.004）。ALC/AMC-DX 是一种低成本、标准化的生物标志物，可预测 NLPHL 的临床结局。
