title: Peripheral blood absolute lymphocyte/monocyte ratio recovery during ABVD treatment cycles predicts clinical outcomes in classical Hodgkin lymphoma.
abstract: The peripheral blood absolute lymphocyte/monocyte count ratio at diagnosis (ALC/AMC-DX) predicts survival in classical Hodgkin lymphoma (cHL). However, a limitation of the ALC/AMC-DX is the inability to assess sequentially the host/tumor interaction during treatment. Therefore, we retrospectively examined the ALC/AMC ratio, as a surrogate marker of host immunity (ALC) and tumor microenvironment (AMC), at each adriamycin, bleomycin, vinblastine and dacarbazine treatment cycle as a predictor for clinical outcomes. From 1990 until 2008, 190 cHL patients were diagnosed, treated and followed at Mayo Clinic Rochester and qualified for the study. The ALC/AMC ratio at each treatment cycle was a predictor for overall survival (OS) and progression-free survival (PFS). An ALC/AMC ratio 1.1 versus ALC/AMC <1.1 during treatment cycles was an independent predictor for OS (hazard ratio (HR)=0.14; 95% confidence interval (CI): 0.04-0.40; P<0.0002) and for PFS (HR=0.19; 95% CI: 0.05-0.82; P<0.03). The ALC/AMC ratio during treatment cycles is a predictor for survival and provides a platform to develop therapeutic modalities to manipulate the ALC/AMC ratio during chemotherapy to improve clinical outcomes in cHL.
authors.affiliation: Division of Hematology, Department of Internal Medicine, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: L F
authors.initials: LF
authors.lastname: Porrata
authors.forename: K M
authors.initials: KM
authors.lastname: Ristow
authors.forename: T M
authors.initials: TM
authors.lastname: Habermann
authors.forename: W R
authors.initials: WR
authors.lastname: Macon
authors.forename: T E
authors.initials: TE
authors.lastname: Witzig
authors.forename: J P
authors.initials: JP
authors.lastname: Colgan
authors.forename: D J
authors.initials: DJ
authors.lastname: Inwards
authors.forename: S M
authors.initials: SM
authors.lastname: Ansell
authors.forename: I N
authors.initials: IN
authors.lastname: Micallef
authors.forename: P B
authors.initials: PB
authors.lastname: Johnston
authors.forename: G
authors.initials: G
authors.lastname: Nowakowski
authors.forename: C A
authors.initials: CA
authors.lastname: Thompson
authors.forename: S N
authors.initials: SN
authors.lastname: Markovic