title: Peripheral blood lymphocyte/monocyte ratio at diagnosis and survival in nodular lymphocyte-predominant Hodgkin lymphoma.
abstract: The pathological background in nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) consists of lymphocytes and histocytes. This study analysed the peripheral blood absolute lymphocyte count/absolute monocyte count ratio at diagnosis (ALC/AMC-DX) on the impact of survival in NLPHL. One hundred and three consecutive NLPHL patients that were followed at Mayo Clinic from 1974 to 2010 were included in the study. Receiver operating characteristic and area under the curve were used for ALC/AMC-DX cut-off value analysis and proportional-hazards models were used to compare survival based on the ALC/AMC-DX ratio. With a median follow-up of 8·9 years (range: 0·3-31 years), an ALC/AMC-DX ≥2·1 was the best cut-off value for survival with an area under the curve of 0·82, a sensitivity of 70% and specificity of 84%. After adjusting for the International Prognostic Score (IPS), ALC/AMC-DX remained an independent prognostic factor for overall survival [Hazard Ratio (HR), 0·33, 95% confidence interval (CI), 0·15-0·71%, P < 0·004]; lymphoma-specific survival (HR, 0·05; 95%CI, 0·01-0·68%, P < 0·002); progression-free survival (HR, 0·30; 95%CI, 0·14-0·60%, P < 0·006), and time to progression (HR, 0·06, 95%CI, 0·04-0·30%, P < 0·004). ALC/AMC-DX is a low cost, already standarized, biomarker to predict clinical outcomes in NLPHL.
authors.affiliation: Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA. porrata.luis@mayo.edu
authors.forename: Luis F
authors.initials: LF
authors.lastname: Porrata
authors.forename: Kay
authors.initials: K
authors.lastname: Ristow
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Habermann
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Witzig
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Colgan
authors.forename: David J
authors.initials: DJ
authors.lastname: Inwards
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Ansell
authors.forename: Ivana N
authors.initials: IN
authors.lastname: Micallef
authors.forename: Patrick B
authors.initials: PB
authors.lastname: Johnston
authors.forename: Grzegorz S
authors.initials: GS
authors.lastname: Nowakowski
authors.forename: Carrie
authors.initials: C
authors.lastname: Thompson
authors.forename: Svetomir N
authors.initials: SN
authors.lastname: Markovic
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005189:False Positive Reactions; D005260:Female; D006689:Hodgkin Disease / Q000097:blood* / Q000473:pathology / Q000628:therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D007958:Leukocyte Count; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000473:pathology*; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult