The Analysis of Prognostic Significance of Absolute Lymphocyte Count and Lymphocyte-to-Monocyte Ratio in Diffuse Large B-Cell Lymphoma

【Objective】 To evaluate the prognostic value of absolute lymphocyte count (ALC)and lymphocyte-to-monocyte ratio (LMR) in Diffuse large B-cell lymphoma(DLBCL) when they are diagnosised. 【Methods】 Sixty-nine cases were analyzed retrospectively, including sex, age, stage, B symptoms, absolute lymphocyte count, absolute monocyte count, lymphocyte-to-monocyte ratio, lactate dehydrogenase, IPI score, bulky disease, ECOG performance status, number of extranodal involvement. Thirty-four received CHOP treatment (cyclophosphamide, vincristine, adriamycin, dexamethasone) , thirty-five received R-CHOP (rituximab plus CHOP). The ALC, AMC, LMR cutoff value for survival analysis were 1.0×109/L, 0.3×109/L, 2.6 respectively. All data were analyzed by statistical package for the social sciences (SPSS) software ‘‘version 18.’’ Chi-square test wasused to compare the difference between two groups of means. The Kaplan–Meier method was used to summarize OS and PFS and the logrank test was used for univariable analysis. The Cox proportional hazards model was used for multivariable analyses of measured factors. 【Results】 1. Patients with ALC<1.0×109/L had a high incidence of advanced Ann Arbor stage (P=0.003) , B symptoms (P=0.001) , elevated LDH level (P<0.001), high IPI score (P<0.001) and high ECOG score (P=0.001). Similar results were observed in patients with LMR<2.6. Patients with LMR<2.6 had a high incidence of advanced Ann Arbor stage (P<0.001) , B symptoms (P=0.005) , elevated LDH level (P<0.001), high IPI score (P<0.001) and high ECOG score (P=0.006). 2. In comparison with CHOP and RCHOP treatment, OS was significant longer with rituximab, as well as PFS(P＜0.05). 3. After a median 41.5 months follow-up, K-M analysis showed that lower ALC and LMR associated with inferior overall survival (OS) and progression free survival (PFS) (P＜0.001). In CHOP treatment group, patients with lower ALC and LMR seemed to have worse OS and PFS ( ALC: P=0.002 in OS,and P=0.005 in PFS; LMR: P=0.011 in OS, and P=0.027 in PFS). We got the same results in RCHOP set (ALC: P=0.001 in OS ; P=0.001 in PFS / LMR: P=0.001 in OS ; P=0.002 in PFS). 4. In multivariate analysis, only ALC were proven as an independent prognosis factor of survival(P<0.05). 【Conclusions】 the ALC and LMR at diagnosis were independent prognostic factors of both OS and PFS for patients with DLBCL. These data suggest that ALC can be used in combination with other prognostic features to better predict the outcome of DLBCL. Disclosures No relevant conflicts of interest to declare.