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Blood lymphocyte-to-monocyte ratio identifies high-risk patients in diffuse large B-cell lymphoma treated with R-CHOP.
- Source :
-
PloS one [PLoS One] 2012; Vol. 7 (7), pp. e41658. Date of Electronic Publication: 2012 Jul 23. - Publication Year :
- 2012
-
Abstract
- Background: Recent research has shown a correlation between immune microenvironment and lymphoma biology. This study aims to investigate the prognostic significance of the immunologically relevant lymphocyte-to-monocyte ratio (LMR), in diffuse large B-cell lymphoma (DLBCL) in the rituximab era.<br />Methodology/principal Findings: We analyzed retrospective data from 438 newly diagnosed DLBCL patients treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) therapy. We randomly selected 200 patients (training set) to generate a cutoff value for LMR by receiver operating characteristic (ROC) curve analysis. LMR was then analyzed in a testing set (nā=ā238) and in all patients (nā=ā438) for validation. The LMR cutoff value for survival analysis determined by ROC curve in the training set was 2.6. Patients with low LMR tended to have more adverse clinical characteristics. Low LMR at diagnosis was associated with worse survival in DLBCL, and could also identify high-risk patients in the low-risk IPI category. Multivariate analysis identified LMR as an independent prognostic factor of survival in the testing set and in all patients.<br />Conclusions/significance: Baseline LMR, a surrogate biomarker of the immune microenvironment, is an effective prognostic factor in DLBCL patients treated with R-CHOP therapy. Future prospective studies are required to confirm our findings.
- Subjects :
- Aged
Antibodies, Monoclonal, Murine-Derived therapeutic use
Cyclophosphamide therapeutic use
Doxorubicin therapeutic use
Female
Humans
Kaplan-Meier Estimate
Leukocyte Count
Lymphoma, Large B-Cell, Diffuse diagnosis
Lymphoma, Large B-Cell, Diffuse pathology
Male
Middle Aged
Monocytes pathology
Multivariate Analysis
Prednisone therapeutic use
Prognosis
Proportional Hazards Models
ROC Curve
Risk Factors
Rituximab
Treatment Outcome
Vincristine therapeutic use
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Lymphoma, Large B-Cell, Diffuse blood
Lymphoma, Large B-Cell, Diffuse drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1932-6203
- Volume :
- 7
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- PloS one
- Publication Type :
- Academic Journal
- Accession number :
- 22911837
- Full Text :
- https://doi.org/10.1371/journal.pone.0041658