title: 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.
abstract: BACKGROUND
  Although most patients with classical Hodgkin's lymphoma (cHL) have a long survival duration, the current risk stratification is imperfect. A recent study suggested a prognostic role for the peripheral blood absolute lymphocyte count/absolute monocyte count (ALC/AMC) ratio at diagnosis in cHL. It is intriguing to investigate the significance of the ALC/AMC ratio in relation to tumor-associated macrophages (TAMs), yet another prognostic factor for cHL.
  
  
  METHODS
  We examined the prognostic impact of the ALC, AMC, and ALC/AMC ratio in 312 cHL patients (median age, 37 years) using receiver operating characteristic curve analysis for optimal cutoff values, and compared these with TAM content.
  
  
  RESULTS
  The median follow-up was 65 months (range, 0.1-245 months). On univariate analysis, a low ALC/AMC ratio (<2.9) was correlated with a poorer overall survival (OS) outcome. A subgroup analysis of patients with limited-stage disease showed that the ALC/AMC ratio was significantly correlated with the OS time. Multivariate analysis showed the ALC/AMC ratio to be an independent prognostic factor for OS outcome. A Spearman correlation test of TAM content showed a negative correlation with the ALC/AMC ratio and a positive correlation with the peripheral blood macrophage percentage.
  
  
  CONCLUSIONS
  This study suggests that the ALC/AMC ratio may be a simple, inexpensive, and independent prognostic factor for OS outcome in patients with cHL and may have a role in the stratification of cHL patients in addition to the International Prognostic Score and TAM content.
authors.affiliation: Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Seoul, Korea.
authors.forename: Young Wha
authors.initials: YW
authors.lastname: Koh
authors.forename: Hyo Jeong
authors.initials: HJ
authors.lastname: Kang
authors.forename: Chansik
authors.initials: C
authors.lastname: Park
authors.forename: Dok Hyun
authors.initials: DH
authors.lastname: Yoon
authors.forename: Shin
authors.initials: S
authors.lastname: Kim
authors.forename: Cheolwon
authors.initials: C
authors.lastname: Suh
authors.forename: Heounjeong
authors.initials: H
authors.lastname: Go
authors.forename: Ji Eun
authors.initials: JE
authors.lastname: Kim
authors.forename: Chul-Woo
authors.initials: CW
authors.lastname: Kim
authors.forename: Jooryung
authors.initials: J
authors.lastname: Huh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000378:metabolism; D015214:Antigens, Differentiation, Myelomonocytic / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D005260:Female; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000473:pathology; D008264:Macrophages / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000473:pathology*; D015999:Multivariate Analysis; D011379:Prognosis; D011956:Receptors, Cell Surface / Q000378:metabolism; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D015996:Survival Rate; D055815:Young Adult; D000098902:CD163 Antigen; D000097382:CD68 Molecule
chemical_list: D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D011956:Receptors, Cell Surface; D000098902:CD163 Antigen; C067980:CD68 antigen, human; D000097382:CD68 Molecule