Prognostic role of peripheral blood lymphocyte/monocyte ratio at diagnosis in diffuse large B-cell lymphoma: a meta-analysis

Leuk Lymphoma. 2015;56(9):2563-8. doi: 10.3109/10428194.2015.1014367. Epub 2015 Mar 3.

Abstract

To evaluate the prognostic value of the absolute lymphocyte count/absolute monocyte count ratio (ALC/AMC ratio) at diagnosis in diffuse large B-cell lymphoma (DLBCL), we performed a meta-analysis of published studies that provided survival information with reference to the ALC/AMC ratio at diagnosis. Nine studies covering a total of 4198 subjects were included in this analysis. The summary hazard ratios of low ALC/AMC ratio for overall survival were 2.00 (p = 0.000) in the population that received R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) and 1.12 (p = 0.479) in the population that received CHOP. The corresponding ratios for event-free survival and progression-free survival were 1.93 (p = 0.000) and 2.31 (p = 0.000) in the population that received R-CHOP. These results may justify risk-adapted therapeutic strategies for patients with DLBCL treated with R-CHOP to account for the ALC/AMC ratio at diagnosis.

Keywords: Diffuse large B-cell lymphoma; lymphocyte; meta-analysis; monocyte; prognosis.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Monoclonal, Murine-Derived / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Cyclophosphamide / administration & dosage
  • Cyclophosphamide / therapeutic use
  • Disease-Free Survival
  • Doxorubicin / administration & dosage
  • Doxorubicin / therapeutic use
  • Humans
  • Leukocyte Count
  • Lymphocyte Count
  • Lymphocytes / pathology*
  • Lymphoma, Large B-Cell, Diffuse / blood
  • Lymphoma, Large B-Cell, Diffuse / diagnosis
  • Lymphoma, Large B-Cell, Diffuse / drug therapy*
  • Monocytes / pathology*
  • Outcome Assessment, Health Care / methods
  • Outcome Assessment, Health Care / statistics & numerical data
  • Prednisone / administration & dosage
  • Prednisone / therapeutic use
  • Prognosis
  • Proportional Hazards Models
  • Rituximab / administration & dosage
  • Vincristine / administration & dosage
  • Vincristine / therapeutic use

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • R-CHOP protocol
  • Rituximab
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone