JCT  Vol.4 No.3 A , March 2013
Absolute Lymphocyte/Monocyte Ratio at Diagnosis and Interim Positron-Emission Tomography Predict Survival in Classical Hodgkin Lymphoma
Abstract: Interim Positron-Emission Tomography (int-PET) and the peripheral blood absolute lymphocyte/monocyte ratio at di- agnosis (ALC/AMC-DX) have been shown to be predictors for progression-free survival (PFS) and time to progression (TTP) in classical Hodgkin lymphoma (cHL). Therefore, we studied if the combination of ALC/AMC-DX and the (int-PET) can further stratified PFS and TTP in cHL patients. Patients were required to be diagnosed, treated, and followed with int-PET at Mayo Clinic, Rochester, Minnesota. From 2000 until 2008, 111 cHL patients qualified for the study. The median follow-up was 2.8 years (range: 0.3 - 10.4 years). Patients with a negative int-PET (N = 98) pre- sented with a higher ALC/AMC-DX (median of 2.32, range: 0.26 - 37.5) compared with patients with a positive int-PET (N = 13) (median of 0.9, range: 0.29 - 3.10), p < 0.004. By multivariate analysis, ALC/AMC-DX and the int-PET were independent predictors for PFS and TTP, when compared with the International prognostic Score. Patients were stratified into four groups: group 1 included patients with a negative int-PET and ALC/AMC-DX ≥ 1.1; group 2 included positive int-PET and ALC/AMC-DX ≥ 1.1; group 3 included negative int-PET and ALC/AMC-DX < 1.1; and group 4 included positive int-PET and ALC/AMC-DX < 1.1. Group 1 experienced superior PFS and TTP in comparison with the other groups. In conclusion, the combination of ALC/AMC-DX and the int-PET provides a simple model to assess clinical outcomes in cHL.
Cite this paper: L. Porrata, K. Ristow, T. Habermann, T. Witzig, J. Colgan, D. Inwards, S. Ansell, I. Micallef, P. Johnston, G. Nowakowski, C. Thompson and S. Markovic, "Absolute Lymphocyte/Monocyte Ratio at Diagnosis and Interim Positron-Emission Tomography Predict Survival in Classical Hodgkin Lymphoma," Journal of Cancer Therapy, Vol. 4 No. 3, 2013, pp. 452-459. doi: 10.4236/jct.2013.43A055.

[1]   L. F. Porrata, K. Ristow, J. P. Colgan, T. M. Habermann, T. E. Witzig, D. J. Inwards, et al., “Peripheral Blood Lymphocyte/Monocyte Ratio at Diagnosis and Survival in Classical Hodgkin’s Lymphoma,” Hematologica, Vol. 97, No 2, 2012, pp. 262-269. doi:10.3324/haematol.2011.050138

[2]   Y. W. Koh, H. J. Kang, C. Park, D. H. Yoon, S. Kim, et al., “The Ratio of the Absolute Lymphocyte Count to the Absolute Monocyte Count Is Associated with Prognosis in Hodgkin’s Lymphoma: Correlation with Tumor Associated Macrophages,” Oncologist, Vol. 17, No. 6, 2012, pp. 871-880.

[3]   T. Terasawa, J. Lau, S. Bardet, O. Couturier, T. Hotta, M. Hutchings, et al., “Fluorine-18-Fluorodeoxyglucose Positron Emission Tomography for Interim Response Assessment of Advanced-Stage Hodgkin’s Lymphoma and Diffuse Large B-Cell Lymphoma: A Systemic Review,” Journal of Clinical Oncology Vol. 27, No. 11, 2009, pp. 19061914. doi:10.1200/JCO.2008.16.0861

[4]   A. Romano, C. Vetro, D. Donnarumma, S. Forte, M. Ippolito and F. Di Raimondo, “Early Interim 2-(1)Fluoro-2deoxy-D-glucose Positron Emission Tomography Is Prognostically Superior to Peripheral Blood Lymphocyte/Monocyte Ratio at Diagnosis in Classical Hodgkin’s Lymphoma,” Haematologica, Vol. 97, No. 6, 2012, pp. e22-e23. doi:10.3324/haematol.2012.064576

[5]   C. J. Cox, T. M. Habermann, B. A. Payne, G. G. Klee, and R. V. Pierre. “Evaluation of the Coulter Counter Model S-Puls IV,” American Journal of Clinical Pathology, Vol. 84, No. 3, 1985, pp. 297-306.

[6]   D. Hasenclever, V. Diehl, J. O. Armitage, D. Assouline, M. Bjorkholm, E. Brusamolino, et al., “A Prognostic Score for Advanced Hodgkin’s Disease,” New England Journal of Medicine, Vol. 339, No. 21, 1998, pp. 1506-1514. doi:10.1056/NEJM199811193392104

[7]   B. D. Chelson, B. Pfistner, M. E. Juweid, R. D. Gascoyne, L. Specht, S. J. Horning, et al., “Revised Response Criteria for Malignant Lymphoma,” Journal of Clinical Oncology, Vol. 25, No. 5, 2007, pp. 579-586.

[8]   E. Kaplan and P. Meier, “Nonparametric Estimation from Incomplete Observations,” Journal of the American Statistical Association Vol. 53, No. 282, 1958, pp. 457-481. doi:10.1080/01621459.1958.10501452

[9]   D. R. Cox, “Regression Models and Life-Tables,” Journal of the Royal Statistical Society series B, Vol. 34, No. 2, 1972, pp. 187-202