Τίτλος:
Prognostic implication of the absolute lymphocyte to absolute monocyte count ratio in patients with classical hodgkin lymphoma treated with doxorubicin, bleomycin, vinblastine, and dacarbazine or equivalent regimens
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Low absolute lymphocyte count (ALC) to absolute monocyte count (AMC) ratio (ALC/AMC) is an independent prognostic factor in Hodgkin lymphoma (HL), but different cutoffs (1.1, 1.5, and 2.9) have been applied. We aimed to validate the prognostic significance of ALC/AMC in 537 homogenously treated (doxorubicin, bleomycin, vinblastine, and dacarbazine or equivalents 6 radiotherapy) classical HL patients at various cutoffs. The median ALC/AMC was 2.24 (0.44-20.50). The median AMC was 0.653 X 109/L (0.050-2.070). Lower ALC/ AMC was associated with established markers of adverse prognosis. In total, 477 (89%), 418 (78%), and 189 (35%) patients had an ALC/AMC ratio of $1.1, $1.5, and $2.9; respectively; 20% had monocytosis ($0.9 X 109/L).Ten-year time to progression (TTP) was 77% versus 55% for patients with ALC/AMC $1.1 and <1.1 (p =.0002), 76% versus 68% for ALC/AMC $1.5 and <1.5 (p =.049), 77% versus 73% for ALC/AMC $2.9 and <2.9 (p =.35), and 79% versus 70% for ALC/AMC $2.24 and <2.24 (p =.08), respectively. In stages IA/IIA and in patients $60 years old, ALC/AMC had no significant effect on TTP. In advanced stages, ALC/AMC was significant only at the cutoff of 1.1 (10-year TTP 67% vs. 48%; p =.016). In younger, advanced-stage patients, the differences were more pronounced. In multivariate analysis of TTP, ALC/AMC < 1.1 (p =.007) and stage IV (p <.001) were independent prognostic factors; ALC/AMC was independent of International Prognostic Score in another model. ALC/AMC was more predictive of overall survival than TTP. At the cutoff of 1.1, ALC/AMC had independent prognostic value in multivariate analysis. However, the prognostically inferior group comprised only 11% of patients. Further research is needed prior to the widespread use of this promising marker. © AlphaMed Press 2016.
Συγγραφείς:
Vassilakopoulos, T.P.
Dimopoulou, M.N.
Angelopoulou, M.K.
Petevi, K.
Pangalis, G.A.
Moschogiannis, M.
Dimou, M.
Boutsikas, G.
Kanellopoulos, A.
Gainaru, G.
Plata, E.
Flevari, P.
Koutsi, K.
Papageorgiou, L.
Telonis, V.
Tsaftaridis, P.
Sachanas, S.
Yiakoumis, X.
Tsirkinidis, P.
Viniou, N.-A.
Siakantaris, M.P.
Variami, E.
Kyrtsonis, M.-C.
Meletis, J.
Panayiotidis, P.
Konstantopoulos, K.
Περιοδικό:
The oncologist
Λέξεις-κλειδιά:
bleomycin; chlormethine; cyclophosphamide; dacarbazine; doxorubicin; epirubicin; etoposide; prednisone; procarbazine; vinblastine; vincristine; antineoplastic agent; bleomycin; dacarbazine; doxorubicin; vinblastine, absolute lymphocyte to absolute monocyte count ratio; adolescent; adult; aged; Article; assessment of humans; cancer growth; female; Hodgkin disease; human; major clinical study; male; monocytosis; multiple cycle treatment; overall survival; priority journal; retrospective study; Hodgkin disease; lymphocyte; lymphocyte count; lymphocytopenia; middle aged; monocyte; multimodality cancer therapy; pathology; very elderly; young adult, Adolescent; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Combined Modality Therapy; Dacarbazine; Doxorubicin; Female; Hodgkin Disease; Humans; Lymphocyte Count; Lymphocytes; Lymphopenia; Male; Middle Aged; Monocytes; Retrospective Studies; Vinblastine; Young Adult
DOI:
10.1634/theoncologist.2015-0251
