Should the cut-off values of the lymphocyte to monocyte ratio for prediction of prognosis in diffuse large B-cell lymphoma be changed in elderly patients?
Young Wha Koh
Department of Pathology, Ajou University School of Medicine, Suwon, Korea
Search for more papers by this authorChan-Sik Park
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Search for more papers by this authorDok Hyun Yoon
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Search for more papers by this authorCheolwon Suh
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Search for more papers by this authorCorresponding Author
Jooryung Huh
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Correspondence Jooryung Huh, Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Seoul 138-736, Korea. Tel: +82-2-3010-4553; Fax: +82-2-472-7898; e-mail: [email protected]Search for more papers by this authorYoung Wha Koh
Department of Pathology, Ajou University School of Medicine, Suwon, Korea
Search for more papers by this authorChan-Sik Park
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Search for more papers by this authorDok Hyun Yoon
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Search for more papers by this authorCheolwon Suh
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Search for more papers by this authorCorresponding Author
Jooryung Huh
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Correspondence Jooryung Huh, Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Seoul 138-736, Korea. Tel: +82-2-3010-4553; Fax: +82-2-472-7898; e-mail: [email protected]Search for more papers by this authorAbstract
Objectives
A recent study suggested a prognostic role for the peripheral blood absolute lymphocyte/monocyte ratio (LMR) at diagnosis of diffuse large B-cell lymphoma (DLBCL). Here, we investigated the significance of LMR in DLBCL patients in relation to advanced age.
Methods
We examined the prognostic impact of LMR in 603 DLBCL treated with rituximab plus CHOP, using the receiver operating characteristic curve analysis for optimal cut-off values, and performed a subgroup analysis according to age.
Results
In elderly groups (age ≥ 70), absolute monocyte count was significantly increased, whereas LMR was significantly decreased compared to younger groups. Patients under 70 yr of age with LMR <3.04 had significantly lower overall survival (OS) and progression-free survival (PFS) compared to those with LMR ≥3.04 (P < 0.001 for both). However, in elderly patients (age ≥ 70), there was no significant difference in OS between patients' LMR levels using the 3.04 cut-off value (P = 0.059). Therefore, a new LMR cut-off value of 2.36 was selected in elderly patients, having observed that elderly patients with LMR <2.36 had significantly lower OS compared to those with LMR ≥2.36 (P = 0.021). In multivariate analysis, LMR remained a significant prognostic factor for OS (P = 0.004) or PFS (P < 0.001).
Conclusions
We suggest the use of a different cut-off value of LMR in elderly patients to distinguish high-risk from low-risk groups.
Supporting Information
| Filename | Description |
|---|---|
| ejh12354-sup-0001-FigS1-S2.docxWord document, 1.4 MB | Figure S1. Receiver operating characteristic (ROC) and area under the curve (AUC) for ALC (A) and AMC (B) at diagnosis. Figure S2. Comparison of survival rates according to ALC and AMC. Overall survival (OS) and progression-free survival (PFS) were significantly worse in those with ALC <1438 (A and B) and AMC ≥642 (C and D). In patients with an ALC <1438 and AMC ≥642 had lower OS (E) and PFS (F) rates than cases with an ALC ≥1438 and AMC <642. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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