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Mayo Clin Proc. 2015 Jun;90(6):756-64. doi: 10.1016/j.mayocp.2015.03.025.

Absolute Monocyte Count and Lymphocyte-Monocyte Ratio Predict Outcome in Nodular Sclerosis Hodgkin Lymphoma: Evaluation Based on Data From 1450 Patients.

Author information

1
Hematology-Oncology Unit, Bnai Zion Medical Center, Haifa, Israel; Rappaport Faculty of Medicine, Technion, Haifa, Israel.
2
Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy.
3
Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy. Electronic address: stefano.sacchi@unimore.it.
4
Hematology-Oncology Unit, Emek Medical Center, Afula, Israel.
5
Division of Hematology, Fondazione IRCCS CàGranda, University of Milano, Milan, Italy.
6
Department of Internal Medicine, University of Pavia, IRCCS San Matteo Hospital Foundation, Pavia, Italy.
7
Department of Hematology, AO Sant'Andrea, La Sapienza University, Rome, Italy.
8
Hematology Unit, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Milan, Italy.
9
UO di Ematologia, AOUP Paolo Giaccone, Palermo, Italy.
10
Department of Hematology, Hadassah University Hospital and Hebrew University Medical School, Jerusalem, Israel.

Abstract

OBJECTIVE:

To verify whether absolute monocyte count (AMC) and lymphocyte- monocyte ratio (LMR) at diagnosis are valid prognostic parameters in classical Hodgkin lymphoma (cHL).

PATIENTS AND METHODS:

Data were collected from 1450 patients with cHL treated in Israel and Italy from January 1, 1988, through December 31, 2007.

RESULTS:

The median age of the patients was 33 years (range, 17-72 years), and 70% (1017) of the patients had nodular sclerosis (NS); the median follow-up duration was 87 months. The best cutoff value for AMC was 750 cells/mm(3), and the best ratio for LMR was 2.1. The adverse prognostic impact of an AMC of more than 750 cells/mm(3) was confirmed for the entire cohort, and its clinical significance was particularly evident in patients with NS histology. The progression-free survival (PFS) at 10 years for an AMC of more than 750 cells/mm(3) was 65% (56%-72%), and the PFS at 10 years for an AMC of 750 cells/mm(3) or less was 81% (76%-84%; P<.001). The overall survival (OS) at 10 years for an AMC of more than 750 cells/mm(3) was 78% (70%-85%), and the OS at 10 years for an AMC of 750 cells/mm(3) or less was 88% (84%-90%; P=.01). In multivariate analysis, both AMC and LMR maintained prognostic significance for PFS (hazard ratio [HR], 1.54, P=.006, and HR, 1.50, P=.006) after adjusting for the international prognostic score, whereas the impact on OS was confirmed (HR, 1.56; P=.04) only in patients with NS and an AMC of more than 750 cells/mm(3).

CONCLUSION:

This study confirms that AMC has prognostic value in cHL that is particularly significant in patients with NS subtype histology. This finding links the known impact of macrophages and monocytes in Hodgkin lymphoma with routine clinical practice.

PMID:
26046410
DOI:
10.1016/j.mayocp.2015.03.025
[Indexed for MEDLINE]
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