Clinical Hematology Unit, Internal Medicine Department, Faculty of Medicine, Oncology Center, Mansoura University, Mansoura, Egypt.
Clinical Pathology Department, Hematology Unit, Faculty of Medicine, Oncology Center, Mansoura University, Mansoura, Egypt.
Clin Lymphoma Myeloma Leuk. 2020 Sep;20(9):e606-e615. doi: 10.1016/j.clml.2020.03.007. Epub 2020 Mar 20.
Recently, the lymphocyte to monocyte ratio (LMR) has been proposed as an easily determinable prognostic factor in patients with cancer, including lymphomas. The objective of this study was the evaluation of the impact of baseline absolute lymphocyte count (ALC), absolute monocyte count (AMC), and the LMR on the treatment response and prognosis in follicular lymphoma (FL).
The data of 100 patients with a FL variant, admitted and treated between January 2009 and June 2018, were analyzed.
The area under the receiver operator characteristic curve and cutoff values of ALC, AMC, and LMR for discrimination between survival times using receiver operating characteristic curves showed 0.57 × 10/L as the most discriminative ALC cutoff value, 1.235 ×10/L as the most discriminative AMC cutoff value, and 1.63 as the most discriminative LMR cutoff value. Progressive disease and stable disease after first-line therapy and mortality rate were significantly associated with lower ALC, higher AMC, and higher LMR. Shorter overall survival (OS) was significantly associated with patients with lower ALC when compared with those having higher ALC. Shorter OS and progression-free survival (PFS) were significantly associated with higher AMC when compared with those having lower AMC. Shorter OS and PFS were significantly associated with lower LMR when compared with those having higher LMR. High-risk Follicular Lymphoma International Prognostic Index as well as low LMR were considered as risk factors for prediction of OS in all the studied patients with FL in univariate analysis and multivariate analysis.
ALC, AMC, and LMR at diagnosis are simple indices, which reflect the host systemic immunity and can predict the clinical outcomes in FL.
最近，淋巴细胞与单核细胞比值（LMR）已被提出作为癌症患者（包括淋巴瘤）易于确定的预后因素。本研究的目的是评估基线绝对淋巴细胞计数（ALC）、绝对单核细胞计数（AMC）和 LMR 对滤泡淋巴瘤（FL）治疗反应和预后的影响。
分析了 2009 年 1 月至 2018 年 6 月期间收治的 100 例 FL 患者的数据。
使用受试者工作特征曲线分析 ALC、AMC 和 LMR 的曲线下面积和截断值，以区分生存时间，结果显示 0.57×10/L 为最具区分性的 ALC 截断值，1.235×10/L 为最具区分性的 AMC 截断值，1.63 为最具区分性的 LMR 截断值。一线治疗后疾病进展和稳定以及死亡率与较低的 ALC、较高的 AMC 和较高的 LMR 显著相关。与 ALC 较高的患者相比，总生存期（OS）较短的患者与较低的 ALC 显著相关。与 AMC 较低的患者相比，OS 和无进展生存期（PFS）较短的患者与较高的 AMC 显著相关。与 LMR 较高的患者相比，OS 和 PFS 较短的患者与较低的 LMR 显著相关。在单因素和多因素分析中，高危滤泡性淋巴瘤国际预后指数（FLIPI）以及低 LMR 被认为是所有 FL 患者 OS 预测的危险因素。
诊断时的 ALC、AMC 和 LMR 是简单的指标，可反映宿主的全身免疫状态，并可预测 FL 的临床结局。
