Shi Yi-Fen, Wang Na, Huang Zi-Yang, Chen Rong-Rong, Huang Yi-Sha, Zhu Yi-Yi, Xing Chong-Yun, Liang Bin, Yu Kang, Feng Jian-Hua
Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, People's Republic of China.
Health Care Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, People's Republic of China.
Cancer Manag Res. 2020 Aug 10;12:7097-7105. doi: 10.2147/CMAR.S264194. eCollection 2020.
Peripheral monocytes, a key cell type for innate immunity, have been shown to be associated with survival in various types of hematological malignancies. However, no previous studies regarding the prognostic impact of peripheral absolute monocyte count (AMC) in early relapsed B-lineage acute lymphoblastic leukemia (B-ALL) have been reported.
Forty-nine cases of early relapsed adult B-ALL were reviewed. The upper (0.80 × 10/L) and lower limits (0.12 × 10/L) of the normal value for AMC were used as cut-off points. Kaplan-Meier curves and Log rank test were used for comparison of overall survival (OS). The univariate and multivariate Cox proportional hazards models were used for investigating the factors associated with OS.
More than half (59.2%) of all patients showed a normal AMC (0.12-0.80 × 10/L). The median follow-up was 5.3 months from the start of first salvage therapy. Univariate analysis revealed that normal AMC (versus low/high AMC) at the time of relapse was a prognostic factor for improved OS (P = 0.021). On multivariate analysis, normal AMC (versus low/high AMC) at the time of relapse remained an independent prognostic factor for improved OS (hazard ratio = 0.43, P = 0.030).
AMC at the time of relapse, which can be easily derived from routine clinical laboratory testing of complete blood count, might be used as a prognostic marker for survival outcomes in adult patients with early relapsed B-ALL.
外周血单核细胞是先天性免疫的关键细胞类型，已被证明与多种血液系统恶性肿瘤的生存相关。然而，此前尚无关于外周血绝对单核细胞计数（AMC）对早期复发B系急性淋巴细胞白血病（B-ALL）预后影响的研究报道。
回顾了49例早期复发的成人B-ALL病例。将AMC正常值的上限（0.80×10⁹/L）和下限（0.12×10⁹/L）作为截断点。采用Kaplan-Meier曲线和Log秩检验比较总生存期（OS）。使用单因素和多因素Cox比例风险模型研究与OS相关的因素。
超过一半（59.2%）的患者AMC正常（0.12 - 0.80×10⁹/L）。从首次挽救治疗开始的中位随访时间为5.3个月。单因素分析显示，复发时AMC正常（与低/高AMC相比）是OS改善的预后因素（P = 0.021）。多因素分析显示，复发时AMC正常（与低/高AMC相比）仍然是OS改善的独立预后因素（风险比 = 0.43，P = 0.030）。
复发时的AMC可通过全血细胞计数的常规临床实验室检测轻松获得，可能作为早期复发成人B-ALL患者生存结局的预后标志物。
