THE LYMPHOCYTE COUNT AND THE MONOCYTE COUNT AND THE LYMPHOCYTE TO MONOCYTE RATIO AT DIAGNOSIS WERE A PROGNOSTIC PARAMETERS IN DIFFUSE LARGE B-CELL LYMPHOMA: RESULTS FROM A LARGE MULTICENTER STUDY.
(Abstract release date: 05/19/16)
EHA Library. Amine Bekadja M. 06/09/16; 134604; PB1704
Mohamed Amine Bekadja
Contributions
Contributions
Abstract
Abstract: PB1704
Type: Publication Only
Background
There is increasing evidence that tumor microenvironment and host immunity play an important role in lymphoma progression. The absolute lymphocyte count (ALC) and the absolute monocyte count (AMC), calculated from the complete blood count, were considered a surrogate for host immunity.
Aims
The aim of this collaborative multicenter study was to verify the prognostic significance of ALC, AMC and ALC/AMC ratio in a large cohort of newly diagnosed patients with DLBCL and we also examined whether ALC and AMC could be utilized as a simple Independent prognostic factors for survival.
Methods
It is a retrospective and multicenter study carried-out by seven hematology departments in the western of Algeria. 467 patients with DLBCL had been diagnosed during an eight years period (2007-2014). All patients, older than 16 years, were included in the study. The median age at the diagnosis was 54 years (16 to 89). There were 265 males and 202 females. The localized stage (I-II) was 43% and the advanced stage (III-IV) was 57%. The performans status (PS≥2) was 41%. LDH increased level in 47%. The number of extra-nodal involved sites was as follows: 0=26%, 1=43%, 2=19%, ≥3=12%. The IPI score were as follow: low risk=41%, intermediate low risk= 23%, intermediate high risk= 24% and high risk=12%. The IPI-R score were as follow: very good=11%, good=52%, bad=37%. The overall survival (OS) and progression free survival (PFS) were calculated according to Kaplan and Meier method and the survival curves were compared using the Log Rank test. The multi-factorial survival analysis was performed by the use Cox regression test. The end point date was the December the 31st 2015. The median of follow up was 24 months (6-109).
Results
The mono-factorial analysis of OS (comparison of the survival curves) showed: Age (≥60 vs <60) (p=0.5); sex (M vs F) (p=0.04); Performans Status (0-1 vs ≥2) (p=0.06); the Ann Arbor (localized vs advanced stage (p=0.008). Bulky vs no Bulky (p=0.32); B symptoms (A vs B) (p=0.05); LDH (Normal vs Increased) (p=0.4); IPI score (p=0.046); IPI-R score (p=0.16- p=0.002 and p=0.001); ALC (>1000µl vs <1000µl) (p=0.082); AMC (>630/µl vs <630/µl) (p=0.001). ALC/AMC ratio (≥2.11 vs <2.11) (p=0.001). The mono factorial analysis of PFS showed: Sexe (p= 0,247); PS>= 2 (p= 0,325); the Ann Arbor localized vs advanced stage (p=0,089); IPI score (p=0,709); IPI-R score (p= 0,581); LDH> Normal vs Increased (p=0,465); AMC >630 (p= 0,778); ALC>1000 (p=0,155) and the ALC/AMC ratio ≥2.11 vs <2.11(p=0, 03). The multi-factorial analysis of the overall survival showed that the most discriminative prognostic factors were: Age>60 years old (HR=1.77, p=0.002); Female sex (HR=0.58, CI 95% 0.41-0.82, p=0.002); PS<2(HR=0.58, CI 95% 0.41-0.81, p=0.002), ALC>1000 (HR=1.28 IC 95% 0.68-2.42, p=0.043), AMC>630 (HR=0.72 IC 95% 0.45-1.15, p=0.018), ALC/AMC ratio>11 (HR=1.54 IC 95% 0.72-3.02, p=0.02).
Conclusion
This study shows that a simple parameters like absolute lymphocyte count (>1000/mm3) and monocyte count (>630/mm3) and the lymphocyte to monocyte ratio at the diagnosis can easily be used routinely in the evaluation of newly diagnosed diffuse large B-cell lymphoma to identify high –risk patients with a worse survival in the rituximab era.
Session topic: E-poster
Keyword(s): DLBCL, Lymphocyte, Monocyte
Type: Publication Only
Background
There is increasing evidence that tumor microenvironment and host immunity play an important role in lymphoma progression. The absolute lymphocyte count (ALC) and the absolute monocyte count (AMC), calculated from the complete blood count, were considered a surrogate for host immunity.
Aims
The aim of this collaborative multicenter study was to verify the prognostic significance of ALC, AMC and ALC/AMC ratio in a large cohort of newly diagnosed patients with DLBCL and we also examined whether ALC and AMC could be utilized as a simple Independent prognostic factors for survival.
Methods
It is a retrospective and multicenter study carried-out by seven hematology departments in the western of Algeria. 467 patients with DLBCL had been diagnosed during an eight years period (2007-2014). All patients, older than 16 years, were included in the study. The median age at the diagnosis was 54 years (16 to 89). There were 265 males and 202 females. The localized stage (I-II) was 43% and the advanced stage (III-IV) was 57%. The performans status (PS≥2) was 41%. LDH increased level in 47%. The number of extra-nodal involved sites was as follows: 0=26%, 1=43%, 2=19%, ≥3=12%. The IPI score were as follow: low risk=41%, intermediate low risk= 23%, intermediate high risk= 24% and high risk=12%. The IPI-R score were as follow: very good=11%, good=52%, bad=37%. The overall survival (OS) and progression free survival (PFS) were calculated according to Kaplan and Meier method and the survival curves were compared using the Log Rank test. The multi-factorial survival analysis was performed by the use Cox regression test. The end point date was the December the 31st 2015. The median of follow up was 24 months (6-109).
Results
The mono-factorial analysis of OS (comparison of the survival curves) showed: Age (≥60 vs <60) (p=0.5); sex (M vs F) (p=0.04); Performans Status (0-1 vs ≥2) (p=0.06); the Ann Arbor (localized vs advanced stage (p=0.008). Bulky vs no Bulky (p=0.32); B symptoms (A vs B) (p=0.05); LDH (Normal vs Increased) (p=0.4); IPI score (p=0.046); IPI-R score (p=0.16- p=0.002 and p=0.001); ALC (>1000µl vs <1000µl) (p=0.082); AMC (>630/µl vs <630/µl) (p=0.001). ALC/AMC ratio (≥2.11 vs <2.11) (p=0.001). The mono factorial analysis of PFS showed: Sexe (p= 0,247); PS>= 2 (p= 0,325); the Ann Arbor localized vs advanced stage (p=0,089); IPI score (p=0,709); IPI-R score (p= 0,581); LDH> Normal vs Increased (p=0,465); AMC >630 (p= 0,778); ALC>1000 (p=0,155) and the ALC/AMC ratio ≥2.11 vs <2.11(p=0, 03). The multi-factorial analysis of the overall survival showed that the most discriminative prognostic factors were: Age>60 years old (HR=1.77, p=0.002); Female sex (HR=0.58, CI 95% 0.41-0.82, p=0.002); PS<2(HR=0.58, CI 95% 0.41-0.81, p=0.002), ALC>1000 (HR=1.28 IC 95% 0.68-2.42, p=0.043), AMC>630 (HR=0.72 IC 95% 0.45-1.15, p=0.018), ALC/AMC ratio>11 (HR=1.54 IC 95% 0.72-3.02, p=0.02).
Conclusion
This study shows that a simple parameters like absolute lymphocyte count (>1000/mm3) and monocyte count (>630/mm3) and the lymphocyte to monocyte ratio at the diagnosis can easily be used routinely in the evaluation of newly diagnosed diffuse large B-cell lymphoma to identify high –risk patients with a worse survival in the rituximab era.
Session topic: E-poster
Keyword(s): DLBCL, Lymphocyte, Monocyte
Abstract: PB1704
Type: Publication Only
Background
There is increasing evidence that tumor microenvironment and host immunity play an important role in lymphoma progression. The absolute lymphocyte count (ALC) and the absolute monocyte count (AMC), calculated from the complete blood count, were considered a surrogate for host immunity.
Aims
The aim of this collaborative multicenter study was to verify the prognostic significance of ALC, AMC and ALC/AMC ratio in a large cohort of newly diagnosed patients with DLBCL and we also examined whether ALC and AMC could be utilized as a simple Independent prognostic factors for survival.
Methods
It is a retrospective and multicenter study carried-out by seven hematology departments in the western of Algeria. 467 patients with DLBCL had been diagnosed during an eight years period (2007-2014). All patients, older than 16 years, were included in the study. The median age at the diagnosis was 54 years (16 to 89). There were 265 males and 202 females. The localized stage (I-II) was 43% and the advanced stage (III-IV) was 57%. The performans status (PS≥2) was 41%. LDH increased level in 47%. The number of extra-nodal involved sites was as follows: 0=26%, 1=43%, 2=19%, ≥3=12%. The IPI score were as follow: low risk=41%, intermediate low risk= 23%, intermediate high risk= 24% and high risk=12%. The IPI-R score were as follow: very good=11%, good=52%, bad=37%. The overall survival (OS) and progression free survival (PFS) were calculated according to Kaplan and Meier method and the survival curves were compared using the Log Rank test. The multi-factorial survival analysis was performed by the use Cox regression test. The end point date was the December the 31st 2015. The median of follow up was 24 months (6-109).
Results
The mono-factorial analysis of OS (comparison of the survival curves) showed: Age (≥60 vs <60) (p=0.5); sex (M vs F) (p=0.04); Performans Status (0-1 vs ≥2) (p=0.06); the Ann Arbor (localized vs advanced stage (p=0.008). Bulky vs no Bulky (p=0.32); B symptoms (A vs B) (p=0.05); LDH (Normal vs Increased) (p=0.4); IPI score (p=0.046); IPI-R score (p=0.16- p=0.002 and p=0.001); ALC (>1000µl vs <1000µl) (p=0.082); AMC (>630/µl vs <630/µl) (p=0.001). ALC/AMC ratio (≥2.11 vs <2.11) (p=0.001). The mono factorial analysis of PFS showed: Sexe (p= 0,247); PS>= 2 (p= 0,325); the Ann Arbor localized vs advanced stage (p=0,089); IPI score (p=0,709); IPI-R score (p= 0,581); LDH> Normal vs Increased (p=0,465); AMC >630 (p= 0,778); ALC>1000 (p=0,155) and the ALC/AMC ratio ≥2.11 vs <2.11(p=0, 03). The multi-factorial analysis of the overall survival showed that the most discriminative prognostic factors were: Age>60 years old (HR=1.77, p=0.002); Female sex (HR=0.58, CI 95% 0.41-0.82, p=0.002); PS<2(HR=0.58, CI 95% 0.41-0.81, p=0.002), ALC>1000 (HR=1.28 IC 95% 0.68-2.42, p=0.043), AMC>630 (HR=0.72 IC 95% 0.45-1.15, p=0.018), ALC/AMC ratio>11 (HR=1.54 IC 95% 0.72-3.02, p=0.02).
Conclusion
This study shows that a simple parameters like absolute lymphocyte count (>1000/mm3) and monocyte count (>630/mm3) and the lymphocyte to monocyte ratio at the diagnosis can easily be used routinely in the evaluation of newly diagnosed diffuse large B-cell lymphoma to identify high –risk patients with a worse survival in the rituximab era.
Session topic: E-poster
Keyword(s): DLBCL, Lymphocyte, Monocyte
Type: Publication Only
Background
There is increasing evidence that tumor microenvironment and host immunity play an important role in lymphoma progression. The absolute lymphocyte count (ALC) and the absolute monocyte count (AMC), calculated from the complete blood count, were considered a surrogate for host immunity.
Aims
The aim of this collaborative multicenter study was to verify the prognostic significance of ALC, AMC and ALC/AMC ratio in a large cohort of newly diagnosed patients with DLBCL and we also examined whether ALC and AMC could be utilized as a simple Independent prognostic factors for survival.
Methods
It is a retrospective and multicenter study carried-out by seven hematology departments in the western of Algeria. 467 patients with DLBCL had been diagnosed during an eight years period (2007-2014). All patients, older than 16 years, were included in the study. The median age at the diagnosis was 54 years (16 to 89). There were 265 males and 202 females. The localized stage (I-II) was 43% and the advanced stage (III-IV) was 57%. The performans status (PS≥2) was 41%. LDH increased level in 47%. The number of extra-nodal involved sites was as follows: 0=26%, 1=43%, 2=19%, ≥3=12%. The IPI score were as follow: low risk=41%, intermediate low risk= 23%, intermediate high risk= 24% and high risk=12%. The IPI-R score were as follow: very good=11%, good=52%, bad=37%. The overall survival (OS) and progression free survival (PFS) were calculated according to Kaplan and Meier method and the survival curves were compared using the Log Rank test. The multi-factorial survival analysis was performed by the use Cox regression test. The end point date was the December the 31st 2015. The median of follow up was 24 months (6-109).
Results
The mono-factorial analysis of OS (comparison of the survival curves) showed: Age (≥60 vs <60) (p=0.5); sex (M vs F) (p=0.04); Performans Status (0-1 vs ≥2) (p=0.06); the Ann Arbor (localized vs advanced stage (p=0.008). Bulky vs no Bulky (p=0.32); B symptoms (A vs B) (p=0.05); LDH (Normal vs Increased) (p=0.4); IPI score (p=0.046); IPI-R score (p=0.16- p=0.002 and p=0.001); ALC (>1000µl vs <1000µl) (p=0.082); AMC (>630/µl vs <630/µl) (p=0.001). ALC/AMC ratio (≥2.11 vs <2.11) (p=0.001). The mono factorial analysis of PFS showed: Sexe (p= 0,247); PS>= 2 (p= 0,325); the Ann Arbor localized vs advanced stage (p=0,089); IPI score (p=0,709); IPI-R score (p= 0,581); LDH> Normal vs Increased (p=0,465); AMC >630 (p= 0,778); ALC>1000 (p=0,155) and the ALC/AMC ratio ≥2.11 vs <2.11(p=0, 03). The multi-factorial analysis of the overall survival showed that the most discriminative prognostic factors were: Age>60 years old (HR=1.77, p=0.002); Female sex (HR=0.58, CI 95% 0.41-0.82, p=0.002); PS<2(HR=0.58, CI 95% 0.41-0.81, p=0.002), ALC>1000 (HR=1.28 IC 95% 0.68-2.42, p=0.043), AMC>630 (HR=0.72 IC 95% 0.45-1.15, p=0.018), ALC/AMC ratio>11 (HR=1.54 IC 95% 0.72-3.02, p=0.02).
Conclusion
This study shows that a simple parameters like absolute lymphocyte count (>1000/mm3) and monocyte count (>630/mm3) and the lymphocyte to monocyte ratio at the diagnosis can easily be used routinely in the evaluation of newly diagnosed diffuse large B-cell lymphoma to identify high –risk patients with a worse survival in the rituximab era.
Session topic: E-poster
Keyword(s): DLBCL, Lymphocyte, Monocyte
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