Prognostic significance of the absolute monocyte counts in lung cancer patients with venous thromboembolism.
We investigated the clinical significance of the absolute monocyte count (AMC) as a predictor of the response to anticoagulation and survival in lung cancer patients with venous thromboembolism (VTE). We retrospectively reviewed 1707 patients with pathologically proven lung cancer who visited the hospital between July 2008 and May 2014. Among them, the clinical data of patients newly diagnosed with VTE and treated with anticoagulation were compared between the low and high AMC groups according to the median value of AMC (640/μL) at the time of VTE diagnosis. The incidence of VTE was 7.9 % during the study period. Most of the patients had non-small-cell lung cancer (82.1 %), stage IV (64.2 %), and pulmonary thromboembolism (76.1 %) and were incidentally diagnosed with VTE (76.9 %). The patients' characteristics and laboratory values were not significantly different between the low and high AMC groups. Among patients available for evaluation of the response to anticoagulation, the high AMC group was significantly more refractory to anticoagulation than the low AMC group (no response to anticoagulation, 21.7 vs. 6.8 %, respectively; p = 0.044). Additionally, the high AMC group showed worse overall survival (OS) than the low AMC group (median, 9.6 vs. 5.9 months; p = 0.038). On multivariate analysis, high AMC, low albumin, and advanced stage were independent poor prognostic factors for OS. High AMC is associated with refractoriness to anticoagulation and poor prognosis in lung cancer patients with VTE.
Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Gangnam-ro 79, Jinju, 660-702, Republic of Korea.
Se-Il
SI
Go
Department of Preventive Medicine and Environmental Health Center, Dong-A University College of Medicine, Busan, 602-715, Republic of Korea.
Rock Bum
RB
Kim
Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Gangnam-ro 79, Jinju, 660-702, Republic of Korea.
Haa-Na
HN
Song
Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Gangnam-ro 79, Jinju, 660-702, Republic of Korea.
Myoung Hee
MH
Kang
Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Gangnam-ro 79, Jinju, 660-702, Republic of Korea.
Un Seok
US
Lee
Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Gangnam-ro 79, Jinju, 660-702, Republic of Korea.
Hye Jung
HJ
Choi
Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Gangnam-ro 79, Jinju, 660-702, Republic of Korea.
Wonyong
W
Jo
Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, 660-702, Republic of Korea.
Seung Jun
SJ
Lee
Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, 660-702, Republic of Korea.
Yu Ji
YJ
Cho
Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, 660-702, Republic of Korea.
Yi Yeong
YY
Jeong
Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, 660-702, Republic of Korea.
Ho Cheol
HC
Kim
Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, 660-702, Republic of Korea.
Jong Deog
JD
Lee
Division of Hematology and Medical Oncology, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, 630-723, Republic of Korea.
Seok-Hyun
SH
Kim
Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Gangnam-ro 79, Jinju, 660-702, Republic of Korea.|Gyeongsang Institute of Health Sciences, Jinju, 660-702, Republic of Korea.
Jung-Hun
JH
Kang
Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Gangnam-ro 79, Jinju, 660-702, Republic of Korea. brightree24@gmail.com.|Gyeongsang Institute of Health Sciences, Jinju, 660-702, Republic of Korea. brightree24@gmail.com.
Gyeong-Won
GW
Lee
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007958:Leukocyte Count / Q000379:methods; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D054556:Venous Thromboembolism / Q000473:pathology*
Deep vein thrombosis; Lung neoplasm; Monocyte; Pulmonary thromboembolism