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Leukemia & Lymphoma Volume 57, 2016 - Issue 8
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Original Articles: Clinical

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
 show all
Pages 1839-1847 | Received 30 Nov 2014, Accepted 14 Oct 2015, Published online: 04 Jan 2016
 
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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.

Potential conflict of interest

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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