Vajavaara Heli, Leivonen Suvi-Katri, Jørgensen Judit, Holte Harald, Leppä Sirpa
Research Program Unit Applied Tumor Genomics Faculty of Medicine University of Helsinki Helsinki Finland.
Department of Oncology Helsinki University Hospital Comprehensive Cancer Center Helsinki Finland.
EJHaem. 2022 Jun 23;3(3):681-687. doi: 10.1002/jha2.409. eCollection 2022 Aug.
Low lymphocyte-to-monocyte-ratio (LMR) has been associated with unfavorable survival in patients with diffuse large B-cell lymphoma (DLBCL). To date, however, the impact of LMR on survival has not been examined in a uniformly treated cohort of patients with high-risk aggressive large B-cell lymphoma. We collected peripheral blood absolute lymphocyte counts (ALCs) and absolute monocyte counts (AMC) prior to treatment and calculated LMR from 112 adult patients, who were less than 65 years of age, had age-adjusted International Prognostic Index 2-3, or site-specific risk factors for central nervous system (CNS) recurrence, and were treated in a Nordic Lymphoma Group LBC-05 trial with dose-dense immunochemotherapy and early systemic CNS prophylaxis (www.ClinicalTrials.gov, number NCT01325194). Median pretreatment ALC was 1.40 × 10/l (range, 0.20-4.95), AMC 0.68 × 10/l (range, 0.10-2.62), and LMR 2.08 (range, 0.10-12.00). ALC did not correlate with tumor-infiltrating lymphocytes, AMC did not correlate with tumor-associated macrophages, and neither ALC nor AMC correlated with survival. However, low LMR (<1.72) translated to unfavourable progression-free survival (PFS) (5-year PFS 70% vs. 92%, 0.002) and overall survival (OS) (5-year OS, 77% vs. 92%, 0.020). In the patients with low LMR, relative risk of progression was 4.4-fold (95% confidence interval [CI] 1.60-12.14, 0.004), and relative risk of death was 3.3-fold (95% CI 1.18-9.50, 0.024) in comparison to the patients with high LMR. We conclude that low LMR is an adverse prognostic factor in uniformly treated young patients with high-risk aggressive large B-cell lymphoma.
低淋巴细胞与单核细胞比值（LMR）与弥漫性大B细胞淋巴瘤（DLBCL）患者的不良生存相关。然而，迄今为止，尚未在一组接受统一治疗的高危侵袭性大B细胞淋巴瘤患者中研究LMR对生存的影响。我们收集了112例年龄小于65岁、年龄校正国际预后指数为2 - 3或有中枢神经系统（CNS）复发部位特异性危险因素的成年患者治疗前的外周血绝对淋巴细胞计数（ALC）和绝对单核细胞计数（AMC），并计算LMR。这些患者参加了北欧淋巴瘤组LBC - 05试验，接受剂量密集免疫化疗和早期全身CNS预防（www.ClinicalTrials.gov，编号NCT01325194）。预处理时ALC中位数为1.40×10⁹/L（范围0.20 - 4.95），AMC为0.68×10⁹/L（范围0.10 - 2.62），LMR为2.08（范围0.10 - 12.00）。ALC与肿瘤浸润淋巴细胞无相关性，AMC与肿瘤相关巨噬细胞无相关性，ALC和AMC均与生存无相关性。然而，低LMR（<1.72）转化为不良的无进展生存期（PFS）（5年PFS 70%对92%，P = 0.002）和总生存期（OS）（5年OS 77%对92%，P = 0.020）。与高LMR患者相比，低LMR患者的疾病进展相对风险为4.4倍（95%置信区间[CI] 1.60 - 12.14，P = 0.004），死亡相对风险为3.3倍（95% CI 1.18 - 9.50，P = 0.024）。我们得出结论，低LMR是接受统一治疗的年轻高危侵袭性大B细胞淋巴瘤患者的不良预后因素。
