title: Prognostic value of lymphocyte/monocyte ratio in advanced Hodgkin lymphoma: correlation with International Prognostic Score and tumor associated macrophages.
abstract: We studied the prognostic significance of the absolute lymphocyte/monocyte count ratio (ALC/AMC), its contribution to the prognostic value of the International Prognostic Score (IPS), and evaluated if ALC/AMC could serve as a proxy for the frequency of CD68 + tumor-associated macrophages (TAMs) in 101 patients with advanced Hodgkin lymphoma (HL). The receiver operating characteristic (ROC) curve identified best cut-off values of 2.0 for ALC/AMC and 25% for CD68 + TAM. Patients with ALC/AMC < 2, IPS > 2 and > 25% CD68 + TAM had an inferior overall survival (OS) and event-free survival (EFS). Spearman's test also uncovered a significant correlation between the ALC/AMC and TAM. Multivariate analysis identified ALC/AMC < 2, IPS > 2 and > 25% CD68 + TAM as poor prognostic factors of OS and EFS. After evaluating ALC/AMC and IPS, we stratified patients into three progressively-worse-outcome groups (low-risk: 0 risk factors; intermediate: 1 risk factor; high: 2 risk factors). Our study encourages the combination of ALC/AMC with IPS, for refining risk prediction in advanced HL patients.
authors.affiliation: a Clinic of Hematology, Clinical Center of Serbia , Serbia ;|b Faculty of Medicine, University of Belgrade , Serbia ;
authors.forename: Ljubomir R
authors.initials: LR
authors.lastname: Jakovic
authors.affiliation: a Clinic of Hematology, Clinical Center of Serbia , Serbia ;|b Faculty of Medicine, University of Belgrade , Serbia ;
authors.forename: Biljana S
authors.initials: BS
authors.lastname: Mihaljevic
authors.affiliation: a Clinic of Hematology, Clinical Center of Serbia , Serbia ;|b Faculty of Medicine, University of Belgrade , Serbia ;
authors.forename: Bosko M
authors.initials: BM
authors.lastname: Andjelic
authors.affiliation: a Clinic of Hematology, Clinical Center of Serbia , Serbia ;|b Faculty of Medicine, University of Belgrade , Serbia ;
authors.forename: Andrija D
authors.initials: AD
authors.lastname: Bogdanovic
authors.affiliation: c Department of Histopathology , Clinical Center of Serbia , Serbia ;
authors.forename: Maja D
authors.initials: MD
authors.lastname: Perunicic Jovanovic
authors.affiliation: d Institute of Medical statistics and Informatics, Faculty of Medicine University of Belgrade , Serbia ;
authors.forename: Dragan D
authors.initials: DD
authors.lastname: Babic
authors.affiliation: e Institute of Histology and Embryology, Faculty of Medicine University of Belgrade , Serbia.
authors.forename: Vladimir Z
authors.initials: VZ
authors.lastname: Bumbasirevic
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000378:metabolism; D015214:Antigens, Differentiation, Myelomonocytic / Q000378:metabolism; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D006689:Hodgkin Disease / Q000097:blood* / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D006801:Humans; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000473:pathology; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000473:pathology*; D008264:Macrophages / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000473:pathology*; D009367:Neoplasm Staging; D011379:Prognosis; D012372:ROC Curve; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D016879:Salvage Therapy / Q000379:methods; D059016:Tumor Microenvironment; D055815:Young Adult; D000097382:CD68 Molecule
chemical_list: D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; C067980:CD68 antigen, human; D000097382:CD68 Molecule
keywords: ALC/AMC; Advanced Hodgkin lymphoma; IPS; TAM