ANALYSIS OF CLINICAL PARAMETERS, ABSOLUTE LYMPHOCYTE AND ABSOLUTE MONOCYTE COUNT IN PATIENTS WITH DIFFUSE LARGE B CELL LYMPHOMA
(Abstract release date: 05/19/16)
EHA Library. Jelicic J. 06/09/16; 134639; PB1739
Dr. Jelena Jelicic
Contributions
Contributions
Abstract
Abstract: PB1739
Type: Publication Only
Background
The results of gene expression profiling (GEP) analysis of diffuse large B cell lymphoma (DLBCL) confirmed existence of two subtypes of DLBCL with different outcome. In order to reproduce GEP findings several studies have investigated the potential role of absolute lymphocyte count (ALC), absolute monocyte count (AMC) and ALC/AMC as surrogate markers. However, the contradictory data were reported.
Aims
The aim of this study was to evaluate prognostic significance of clinical parameters, laboratory parameters: ALC, AMC and ALC/AMC on the overall survival (OS) and event free survival (EFS).
Methods
A total of 583 patients (295 females/288 males) with the median age of 60 years (range 18-89) were included in the study. According to the Ann Arbor classification, stage I, II, III and IV had 74 patients (12.7%), 212 (36.4%), 110 (18.9%) and 187 (32.1%), respectively. Bulky disease was present in 190 patients (32.6%) and B symptoms in 370 patients (63.5%). Bone marrow involvement was present in 77 patients (13.2%). Low Revised International Prognostic Index (R-IPI) was presented in 97 patients (16.6%), intermediate in 307 (52.7%) and high in 174 (29.8%). Median ALC at diagnosis was 1.35x109/l (range 0.07-17.8x109/l), AMC 0.60x109/l (range 0.06-8.58x109/l) and ALC/AMC 2.5 (range 0.07-37.0x109/l). Cut off values for LAC, AMC and ALC/AMC were used as previously published and included 1.1x109/l, 0.62x109/l and 2.6x109/l for ALC, AMC and ALC/AMC, respectively. Regarding cell of origin according to Hans algorithm, 45.3% of patients had GC (germinal center) type, while 64.7% had non-GC type. All patients were initially treated with rituximab plus CHOP or CHOP like protocols.
Results
Complete remission (CR) was achieved in 425 patients (72.9%), partial remission (PR) in 79 (13.6%), stable disease (SD) in 19 (3.3%) and progressive disease in 60 (10.3%). Disease relapse was confirmed in 88 patients (15.1%). The patients with B symptoms of disease had inferior OS (Log Rank=11.27, p=0.001) and EFS (Log Rank=12.62, p=0.001) compared to those without B symptoms. Furthermore, presence of bulky disease influenced OD (Log Rank=10.58, p=0.001) and EFS (Log Rank=11.35, p=0.001). The prognostic value of R-IPI was highly statistically significantfor both OS (Log Rank=62.3, p<0.0001) and EFS (Log Rank=56.83, p<0.0001). The patients with GC type had better OS (Log Rank=7.44, p=0.006) and EFS (Log Rank=6.34, p=0.012) compared to non-GC type. However, there was no influence of ALC, AMC and ALC/AMC neither on OS nor EFS. Multivariate analysis among significant parameters (presence of B symptoms, bulky disease, R-IPI and cell of origin GC vs. non-GC type), has pointed out the major impact of R-IPI on OS (HR 1.75, p<0.0001) and (HR 1.44, p=0.0001) along with the presence of B symptoms (OS, HR 1.51, p=0.01; EFS, HR 1.58, p<0.008).
Conclusion
ALC, AMC and ALC/AMC failed to prove influence on survival of DLBCL patients indicating the need for new potential surrogate markers of GEP results. Moreover, R-IPI as clinical prognostic score may help to differentiate risk groups within DLBCL patients.
Session topic: E-poster
Keyword(s): Diffuse large B cell lymphoma, Prognosis
Type: Publication Only
Background
The results of gene expression profiling (GEP) analysis of diffuse large B cell lymphoma (DLBCL) confirmed existence of two subtypes of DLBCL with different outcome. In order to reproduce GEP findings several studies have investigated the potential role of absolute lymphocyte count (ALC), absolute monocyte count (AMC) and ALC/AMC as surrogate markers. However, the contradictory data were reported.
Aims
The aim of this study was to evaluate prognostic significance of clinical parameters, laboratory parameters: ALC, AMC and ALC/AMC on the overall survival (OS) and event free survival (EFS).
Methods
A total of 583 patients (295 females/288 males) with the median age of 60 years (range 18-89) were included in the study. According to the Ann Arbor classification, stage I, II, III and IV had 74 patients (12.7%), 212 (36.4%), 110 (18.9%) and 187 (32.1%), respectively. Bulky disease was present in 190 patients (32.6%) and B symptoms in 370 patients (63.5%). Bone marrow involvement was present in 77 patients (13.2%). Low Revised International Prognostic Index (R-IPI) was presented in 97 patients (16.6%), intermediate in 307 (52.7%) and high in 174 (29.8%). Median ALC at diagnosis was 1.35x109/l (range 0.07-17.8x109/l), AMC 0.60x109/l (range 0.06-8.58x109/l) and ALC/AMC 2.5 (range 0.07-37.0x109/l). Cut off values for LAC, AMC and ALC/AMC were used as previously published and included 1.1x109/l, 0.62x109/l and 2.6x109/l for ALC, AMC and ALC/AMC, respectively. Regarding cell of origin according to Hans algorithm, 45.3% of patients had GC (germinal center) type, while 64.7% had non-GC type. All patients were initially treated with rituximab plus CHOP or CHOP like protocols.
Results
Complete remission (CR) was achieved in 425 patients (72.9%), partial remission (PR) in 79 (13.6%), stable disease (SD) in 19 (3.3%) and progressive disease in 60 (10.3%). Disease relapse was confirmed in 88 patients (15.1%). The patients with B symptoms of disease had inferior OS (Log Rank=11.27, p=0.001) and EFS (Log Rank=12.62, p=0.001) compared to those without B symptoms. Furthermore, presence of bulky disease influenced OD (Log Rank=10.58, p=0.001) and EFS (Log Rank=11.35, p=0.001). The prognostic value of R-IPI was highly statistically significantfor both OS (Log Rank=62.3, p<0.0001) and EFS (Log Rank=56.83, p<0.0001). The patients with GC type had better OS (Log Rank=7.44, p=0.006) and EFS (Log Rank=6.34, p=0.012) compared to non-GC type. However, there was no influence of ALC, AMC and ALC/AMC neither on OS nor EFS. Multivariate analysis among significant parameters (presence of B symptoms, bulky disease, R-IPI and cell of origin GC vs. non-GC type), has pointed out the major impact of R-IPI on OS (HR 1.75, p<0.0001) and (HR 1.44, p=0.0001) along with the presence of B symptoms (OS, HR 1.51, p=0.01; EFS, HR 1.58, p<0.008).
Conclusion
ALC, AMC and ALC/AMC failed to prove influence on survival of DLBCL patients indicating the need for new potential surrogate markers of GEP results. Moreover, R-IPI as clinical prognostic score may help to differentiate risk groups within DLBCL patients.
Session topic: E-poster
Keyword(s): Diffuse large B cell lymphoma, Prognosis
Abstract: PB1739
Type: Publication Only
Background
The results of gene expression profiling (GEP) analysis of diffuse large B cell lymphoma (DLBCL) confirmed existence of two subtypes of DLBCL with different outcome. In order to reproduce GEP findings several studies have investigated the potential role of absolute lymphocyte count (ALC), absolute monocyte count (AMC) and ALC/AMC as surrogate markers. However, the contradictory data were reported.
Aims
The aim of this study was to evaluate prognostic significance of clinical parameters, laboratory parameters: ALC, AMC and ALC/AMC on the overall survival (OS) and event free survival (EFS).
Methods
A total of 583 patients (295 females/288 males) with the median age of 60 years (range 18-89) were included in the study. According to the Ann Arbor classification, stage I, II, III and IV had 74 patients (12.7%), 212 (36.4%), 110 (18.9%) and 187 (32.1%), respectively. Bulky disease was present in 190 patients (32.6%) and B symptoms in 370 patients (63.5%). Bone marrow involvement was present in 77 patients (13.2%). Low Revised International Prognostic Index (R-IPI) was presented in 97 patients (16.6%), intermediate in 307 (52.7%) and high in 174 (29.8%). Median ALC at diagnosis was 1.35x109/l (range 0.07-17.8x109/l), AMC 0.60x109/l (range 0.06-8.58x109/l) and ALC/AMC 2.5 (range 0.07-37.0x109/l). Cut off values for LAC, AMC and ALC/AMC were used as previously published and included 1.1x109/l, 0.62x109/l and 2.6x109/l for ALC, AMC and ALC/AMC, respectively. Regarding cell of origin according to Hans algorithm, 45.3% of patients had GC (germinal center) type, while 64.7% had non-GC type. All patients were initially treated with rituximab plus CHOP or CHOP like protocols.
Results
Complete remission (CR) was achieved in 425 patients (72.9%), partial remission (PR) in 79 (13.6%), stable disease (SD) in 19 (3.3%) and progressive disease in 60 (10.3%). Disease relapse was confirmed in 88 patients (15.1%). The patients with B symptoms of disease had inferior OS (Log Rank=11.27, p=0.001) and EFS (Log Rank=12.62, p=0.001) compared to those without B symptoms. Furthermore, presence of bulky disease influenced OD (Log Rank=10.58, p=0.001) and EFS (Log Rank=11.35, p=0.001). The prognostic value of R-IPI was highly statistically significantfor both OS (Log Rank=62.3, p<0.0001) and EFS (Log Rank=56.83, p<0.0001). The patients with GC type had better OS (Log Rank=7.44, p=0.006) and EFS (Log Rank=6.34, p=0.012) compared to non-GC type. However, there was no influence of ALC, AMC and ALC/AMC neither on OS nor EFS. Multivariate analysis among significant parameters (presence of B symptoms, bulky disease, R-IPI and cell of origin GC vs. non-GC type), has pointed out the major impact of R-IPI on OS (HR 1.75, p<0.0001) and (HR 1.44, p=0.0001) along with the presence of B symptoms (OS, HR 1.51, p=0.01; EFS, HR 1.58, p<0.008).
Conclusion
ALC, AMC and ALC/AMC failed to prove influence on survival of DLBCL patients indicating the need for new potential surrogate markers of GEP results. Moreover, R-IPI as clinical prognostic score may help to differentiate risk groups within DLBCL patients.
Session topic: E-poster
Keyword(s): Diffuse large B cell lymphoma, Prognosis
Type: Publication Only
Background
The results of gene expression profiling (GEP) analysis of diffuse large B cell lymphoma (DLBCL) confirmed existence of two subtypes of DLBCL with different outcome. In order to reproduce GEP findings several studies have investigated the potential role of absolute lymphocyte count (ALC), absolute monocyte count (AMC) and ALC/AMC as surrogate markers. However, the contradictory data were reported.
Aims
The aim of this study was to evaluate prognostic significance of clinical parameters, laboratory parameters: ALC, AMC and ALC/AMC on the overall survival (OS) and event free survival (EFS).
Methods
A total of 583 patients (295 females/288 males) with the median age of 60 years (range 18-89) were included in the study. According to the Ann Arbor classification, stage I, II, III and IV had 74 patients (12.7%), 212 (36.4%), 110 (18.9%) and 187 (32.1%), respectively. Bulky disease was present in 190 patients (32.6%) and B symptoms in 370 patients (63.5%). Bone marrow involvement was present in 77 patients (13.2%). Low Revised International Prognostic Index (R-IPI) was presented in 97 patients (16.6%), intermediate in 307 (52.7%) and high in 174 (29.8%). Median ALC at diagnosis was 1.35x109/l (range 0.07-17.8x109/l), AMC 0.60x109/l (range 0.06-8.58x109/l) and ALC/AMC 2.5 (range 0.07-37.0x109/l). Cut off values for LAC, AMC and ALC/AMC were used as previously published and included 1.1x109/l, 0.62x109/l and 2.6x109/l for ALC, AMC and ALC/AMC, respectively. Regarding cell of origin according to Hans algorithm, 45.3% of patients had GC (germinal center) type, while 64.7% had non-GC type. All patients were initially treated with rituximab plus CHOP or CHOP like protocols.
Results
Complete remission (CR) was achieved in 425 patients (72.9%), partial remission (PR) in 79 (13.6%), stable disease (SD) in 19 (3.3%) and progressive disease in 60 (10.3%). Disease relapse was confirmed in 88 patients (15.1%). The patients with B symptoms of disease had inferior OS (Log Rank=11.27, p=0.001) and EFS (Log Rank=12.62, p=0.001) compared to those without B symptoms. Furthermore, presence of bulky disease influenced OD (Log Rank=10.58, p=0.001) and EFS (Log Rank=11.35, p=0.001). The prognostic value of R-IPI was highly statistically significantfor both OS (Log Rank=62.3, p<0.0001) and EFS (Log Rank=56.83, p<0.0001). The patients with GC type had better OS (Log Rank=7.44, p=0.006) and EFS (Log Rank=6.34, p=0.012) compared to non-GC type. However, there was no influence of ALC, AMC and ALC/AMC neither on OS nor EFS. Multivariate analysis among significant parameters (presence of B symptoms, bulky disease, R-IPI and cell of origin GC vs. non-GC type), has pointed out the major impact of R-IPI on OS (HR 1.75, p<0.0001) and (HR 1.44, p=0.0001) along with the presence of B symptoms (OS, HR 1.51, p=0.01; EFS, HR 1.58, p<0.008).
Conclusion
ALC, AMC and ALC/AMC failed to prove influence on survival of DLBCL patients indicating the need for new potential surrogate markers of GEP results. Moreover, R-IPI as clinical prognostic score may help to differentiate risk groups within DLBCL patients.
Session topic: E-poster
Keyword(s): Diffuse large B cell lymphoma, Prognosis
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