title: [Prognostic value of absolute monocyte count in chronic lymphocytic leukaemia].
abstract: BACKGROUND
  The low peripheral absolute lymphocyte and high monocyte count have been reported to correlate with poor clinical outcome in various lymphomas and other cancers. However, a few data known about the prognostic value of absolute monocyte count in chronic lymphocytic leukaemia.
  
  
  OBJECTIVE
  The aim of the authors was to investigate the impact of absolute monocyte count measured at the time of diagnosis in patients with chronic lymphocytic leukaemia on the time to treatment and overal survival.
  
  
  METHODS
  Between January 1, 2005 and December 31, 2012, 223 patients with newly-diagnosed chronic lymphocytic leukaemia were included. The rate of patients needing treatment, time to treatment, overal survival and causes of mortality based on Rai stages, CD38, ZAP-70 positivity and absolute monocyte count were analyzed.
  
  
  RESULTS
  Therapy was necessary in 21.1%, 57.4%, 88.9%, 88.9% and 100% of patients in Rai stage 0, I, II, III an IV, respectively; in 61.9% and 60.8% of patients exhibiting CD38 and ZAP-70 positivity, respectively; and in 76.9%, 21.2% and 66.2% of patients if the absolute monocyte count was <0.25 G/l, between 0.25-0.75 G/l and >0.75 G/l, respectively. The median time to treatment and the median overal survival were 19.5, 65, and 35.5 months; and 41.5, 65, and 49.5 months according to the three groups of monocyte counts. The relative risk of beginning the therapy was 1.62 (p<0.01) in patients with absolute monocyte count <0.25 G/l or >0.75 G/l, as compared to those with 0.25-0.75 G/l, and the risk of overal survival was 2.41 (p<0.01) in patients with absolute monocyte count lower than 0.25 G/l as compared to those with higher than 0.25 G/l. The relative risks remained significant in Rai 0 patients, too. The leading causes of mortality were infections (41.7%) and the chronic lymphocytic leukaemia (58.3%) in patients with low monocyte count, while tumours (25.9-35.3%) and other events (48.1 and 11.8%) occurred in patients with medium or high monocyte counts.
  
  
  CONCLUSIONS
  Patients with low and high monocyte counts had a shorter time to treatment compared to patients who belonged to the intermediate monocyte count group. The low absolute monocyte count was associated with increased mortality caused by infectious complications and chronic lymphocytic leukaemia. The absolute monocyte count may give additional prognostic information in Rai stage 0, too.
authors.affiliation: Szabolcs-Szatmár-Bereg Megyei Jósa András Oktatókórház Hematológiai Osztály Nyíregyháza Szent István u. 68. 4400.
authors.forename: László
authors.initials: L
authors.lastname: Szerafin
authors.affiliation: Szabolcs-Szatmár-Bereg Megyei Jósa András Oktatókórház Hematológiai Osztály Nyíregyháza Szent István u. 68. 4400.
authors.forename: János
authors.initials: J
authors.lastname: Jakó
authors.affiliation: Szabolcs-Szatmár-Bereg Megyei Jósa András Oktatókórház Sürgősségi Betegellátó Centrum Nyíregyháza.
authors.forename: Ferenc
authors.initials: F
authors.lastname: Riskó
mesh_terms: D051997:ADP-ribosyl Cyclase 1 / Q000378:metabolism*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000201:enzymology / Q000276:immunology* / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D007958:Leukocyte Count; D008297:Male; D008562:Membrane Glycoproteins / Q000378:metabolism*; D008875:Middle Aged; D009000:Monocytes; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D051746:ZAP-70 Protein-Tyrosine Kinase / Q000378:metabolism*
chemical_list: D008562:Membrane Glycoproteins; D051746:ZAP-70 Protein-Tyrosine Kinase; C497261:ZAP70 protein, human; C498154:CD38 protein, human; D051997:ADP-ribosyl Cyclase 1
keywords: absolute monocyte count; abszolút monocytaszám; chronic lymphocytic leukaemia; kezelésig eltelt idő; krónikus lymphoid leukaemia; overall survival; prognosis; prognózis; time to treatment; túlélés