Peripheral Blood Lymphocyte-to-Monocyte Ratio at Relapse Predicts Outcome for Patients With Relapsed or Refractory Diffuse Large B-cell Lymphoma in the Rituximab Era |
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| Institution: | 1. Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan;2. Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan;3. Department of Cell Therapy, Institute of Biomedical Research and Innovation, Kobe, Japan;4. Department of General Clinical Research Center, Kobe City Medical Center General Hospital, Kobe, Japan;5. Department of Clinical Pathology, Kobe City Medical Center General Hospital, Kobe, Japan;1. Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, South Korea;2. Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, South Korea;3. Department of Thoracic and Cardiovascular Surgery, Inje University Medical School, Paik General Hospital, Seoul, South Korea;4. Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Medical School, Jeonju, South Korea;5. Department of Thoracic and Cardiovascular Surgery, College of Medicine, Yeungnam University, Daegu, South Korea;1. Department of Surgery, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan;3. Department of Pathology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan;1. Section of Critical Care Medicine, Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, Ohio;2. Division of Cardiac Surgery, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio;3. Department of Nursing, The Ohio State University Wexner Medical Center, Columbus, Ohio;1. Department of Haematology Wyong Hospital, Kanwal, Australia;2. Service of Hematology Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico;3. Hospital Erasto Gaertner, Curitiba, Paraná, Brazil;4. Clinical Hematology and Oncology Clinics of Australasia, Brisbane, Australia;5. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico;6. Medicine School of Sao Paulo University, Sao Paulo, Brazil;7. Instituto Nacional de Cancerología, Mexico;8. Eli Lilly and Company, Indianapolis, IN |
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| Abstract: | BackgroundPatients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL) have a poor prognosis, even in the rituximab era. Several studies have reported the clinical importance of the peripheral blood lymphocyte-to-monocyte ratio (LMR) in various malignancies, including lymphoma. However, the prognostic value of the LMR in relapsed/refractory DLBCL has not been well evaluated. The purpose of the present study was to investigate whether the LMR at relapse can predict clinical outcomes for relapsed/refractory DLBCL patients treated with rituximab.Patients and MethodsWe analyzed data on 74 patients with relapsed/refractory DLBCL, who were initially treated with R-CHOP (rituximab and cyclophosphamide, doxorubicin, vincristine, and prednisone) or an R–CHOP-like regimen.ResultsThere was a significant association between a low LMR (≤ 2.6) and shorter overall survival (OS; P < .001) and progression-free survival (PFS; P < .001) compared with the high LMR group (> 2.6). Multivariate analysis showed that LMR was an independent prognostic factor for OS (P < .001) and PFS (P < .001), as was the international prognostic index (IPI) at relapse for OS. In addition, the LMR had an incremental value for OS and PFS compared with the IPI at relapse.ConclusionThe LMR predicts OS and PFS outcomes in relapsed/refractory DLBCL patients treated with rituximab, and might facilitate better stratification among patients in low- and intermediate-risk IPI groups. |
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| Keywords: | International prognostic index Prognostic factor Salvage chemotherapy Survival |
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