Jakovic Ljubomir R, Mihaljevic Biljana S, Andjelic Bosko M, Bogdanovic Andrija D, Perunicic Jovanovic Maja D, Babic Dragan D, Bumbasirevic Vladimir Z
a Clinic of Hematology, Clinical Center of Serbia , Serbia ;
b Faculty of Medicine, University of Belgrade , Serbia ;
Leuk Lymphoma. 2016 Aug;57(8):1839-47. doi: 10.3109/10428194.2015.1110745. Epub 2016 Jan 4.
We studied the prognostic significance of the absolute lymphocyte/monocyte count ratio (ALC/AMC), its contribution to the prognostic value of the International Prognostic Score (IPS), and evaluated if ALC/AMC could serve as a proxy for the frequency of CD68 + tumor-associated macrophages (TAMs) in 101 patients with advanced Hodgkin lymphoma (HL). The receiver operating characteristic (ROC) curve identified best cut-off values of 2.0 for ALC/AMC and 25% for CD68 + TAM. Patients with ALC/AMC < 2, IPS > 2 and > 25% CD68 + TAM had an inferior overall survival (OS) and event-free survival (EFS). Spearman's test also uncovered a significant correlation between the ALC/AMC and TAM. Multivariate analysis identified ALC/AMC < 2, IPS > 2 and > 25% CD68 + TAM as poor prognostic factors of OS and EFS. After evaluating ALC/AMC and IPS, we stratified patients into three progressively-worse-outcome groups (low-risk: 0 risk factors; intermediate: 1 risk factor; high: 2 risk factors). Our study encourages the combination of ALC/AMC with IPS, for refining risk prediction in advanced HL patients.
我们研究了绝对淋巴细胞/单核细胞计数比值（ALC/AMC）的预后意义、其对国际预后评分（IPS）预后价值的贡献，并评估了ALC/AMC是否可作为101例晚期霍奇金淋巴瘤（HL）患者中CD68 +肿瘤相关巨噬细胞（TAM）频率的替代指标。受试者工作特征（ROC）曲线确定ALC/AMC的最佳截断值为2.0，CD68 + TAM的最佳截断值为25%。ALC/AMC＜2、IPS＞2且CD68 + TAM＞25%的患者总生存期（OS）和无事件生存期（EFS）较差。Spearman检验还发现ALC/AMC与TAM之间存在显著相关性。多变量分析确定ALC/AMC＜2、IPS＞2且CD68 + TAM＞25%是OS和EFS的不良预后因素。在评估ALC/AMC和IPS后，我们将患者分为三个预后逐渐变差的组（低风险：0个风险因素；中风险：1个风险因素；高风险：2个风险因素）。我们的研究鼓励将ALC/AMC与IPS结合，以优化晚期HL患者的风险预测。
