Prognostic value of lymphocyte/monocyte ratio in advanced Hodgkin lymphoma: correlation with International Prognostic Score and tumor associated macrophages

Ljubomir R. JakovicClinic of Hematology, Clinical Center of Serbia, Serbia; ;Faculty of Medicine, University of Belgrade, Serbia; Correspondence[email protected]

Biljana S. MihaljevicClinic of Hematology, Clinical Center of Serbia, Serbia; ;Faculty of Medicine, University of Belgrade, Serbia;

Bosko M. AndjelicClinic of Hematology, Clinical Center of Serbia, Serbia; ;Faculty of Medicine, University of Belgrade, Serbia;

Andrija D. BogdanovicClinic of Hematology, Clinical Center of Serbia, Serbia; ;Faculty of Medicine, University of Belgrade, Serbia;

Maja D. Perunicic JovanovicDepartment of Histopathology, Clinical Center of Serbia, Serbia;

Dragan D. BabicInstitute of Medical statistics and Informatics, Faculty of Medicine University of Belgrade, Serbia;

Vladimir Z. BumbasirevicInstitute of Histology and Embryology, Faculty of Medicine University of Belgrade, Serbia

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Abstract

We studied the prognostic significance of the absolute lymphocyte/monocyte count ratio (ALC/AMC), its contribution to the prognostic value of the International Prognostic Score (IPS), and evaluated if ALC/AMC could serve as a proxy for the frequency of CD68 + tumor-associated macrophages (TAMs) in 101 patients with advanced Hodgkin lymphoma (HL). The receiver operating characteristic (ROC) curve identified best cut-off values of 2.0 for ALC/AMC and 25% for CD68 + TAM. Patients with ALC/AMC < 2, IPS > 2 and > 25% CD68 + TAM had an inferior overall survival (OS) and event-free survival (EFS). Spearman’s test also uncovered a significant correlation between the ALC/AMC and TAM. Multivariate analysis identified ALC/AMC < 2, IPS > 2 and > 25% CD68 + TAM as poor prognostic factors of OS and EFS. After evaluating ALC/AMC and IPS, we stratified patients into three progressively-worse-outcome groups (low-risk: 0 risk factors; intermediate: 1 risk factor; high: 2 risk factors). Our study encourages the combination of ALC/AMC with IPS, for refining risk prediction in advanced HL patients.

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Disclosure forms provided by the authors are available with the full text of this article at http://dx.doi.org/10.3109/10428194.2015.1110745.

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Prognostic value of lymphocyte/monocyte ratio in advanced Hodgkin lymphoma: correlation with International Prognostic Score and tumor associated macrophages

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Prognostic value of lymphocyte/monocyte ratio in advanced Hodgkin lymphoma: correlation with International Prognostic Score and tumor associated macrophages

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