Contributions
Abstract: PB2003
Type: Publication Only
Background
Decline the absolute lymphocyte count in the peripheral blood of less than 8% for Hodgkin's lymphoma is an unfavorable prognostic factor, but with the development of induction chemotherapy, it lost significance in the revised IPS-3 scale. To determine the clinical significance of the absolute lymphocyte count, lymphocyte value and the ratio with monocyte we correlated this with present clinical and laboratory features and Progressive-free survival (PFS) after treatment by ABVD (adriamicyn, bleomicyn, vinblastine, dacarbazine).
Aims
Determine the clinical significance of the absolute lymphocyte count, and the ratio lymphocyte with monocyte's to the progression-free survival of patients with Hodgkin's lymphoma treated with the ABVD, according to the other prognostic criteria
Methods
The study included 124 untreated patients with classic Hodgkin's lymphoma from 2002 to 2016, and a median of 29.6 years of age. Inclusion criteria were: a histologically confirmed diagnosis of classical Hodgkin's lymphoma, the time from the onset of the first symptoms of the disease before the start of therapy was 1-2 months. The hemogram examinations till 1-2 days prior to chemotherapy, lymphocyte-monocyte ratio (LMR) was determined by dividing the absolute lymphocyte count on the absolute monocyte count. The minimum duration of follow-up after the last cycle of chemotherapy was not less than 36 months.
Results
In the population of patients (n = 124), 74% (n = 92) patients achieved and maintained a remission status within 36 months - favorable group. 26% (n = 32) of patients did not achieve remission after induction chemotherapy or developed a relapse within 36 months - unfavorable group. In an unfavorable group, 21 patients (64%) had an LMR level less than 2, while in a favorable group in 14 patients (20%) the LMR level was below 2 and 76 patients (80%) had LMR levels in the range 2-5. The disease-free survival (DFS) during 3 years in patients with 3-4 and 4-5 LMR was 92% and only 35% and 61% in groups with LMI <1 and 1-2 respectively (p = 0.038 log rank test). Using the ROC curve, the LMR-1.8 threshold level was determined which had the maximum effect on disease-free survival. With 74% specificity and 54% sensitivity, the ROC curve area was 0.73. Multivariate analysis using the Cox proportional hazard model with the inclusion of decrees level of LMR <2, age 45 and older, B-symptoms, IV stage, anemia, decreased serum albumin, increased LDH, leukocytosis, lymphocytopenia revealed that the decreased of level LMR <2 was an independent factor of poor prognosis (p = 0.028; RR=1,8, CI=0.4-5.2).
Conclusion
The decreased of level lymphocyte-monocyte ratio (LMR) <2 can be an independent prognostic factor of patients with classic lymphoma Hodgkin’s
Session topic: 17. Hodgkin lymphoma – Clinical
Keyword(s): Hodgkin's Lymphoma, Lymphocyte, monocyte, Prognostic factor
Abstract: PB2003
Type: Publication Only
Background
Decline the absolute lymphocyte count in the peripheral blood of less than 8% for Hodgkin's lymphoma is an unfavorable prognostic factor, but with the development of induction chemotherapy, it lost significance in the revised IPS-3 scale. To determine the clinical significance of the absolute lymphocyte count, lymphocyte value and the ratio with monocyte we correlated this with present clinical and laboratory features and Progressive-free survival (PFS) after treatment by ABVD (adriamicyn, bleomicyn, vinblastine, dacarbazine).
Aims
Determine the clinical significance of the absolute lymphocyte count, and the ratio lymphocyte with monocyte's to the progression-free survival of patients with Hodgkin's lymphoma treated with the ABVD, according to the other prognostic criteria
Methods
The study included 124 untreated patients with classic Hodgkin's lymphoma from 2002 to 2016, and a median of 29.6 years of age. Inclusion criteria were: a histologically confirmed diagnosis of classical Hodgkin's lymphoma, the time from the onset of the first symptoms of the disease before the start of therapy was 1-2 months. The hemogram examinations till 1-2 days prior to chemotherapy, lymphocyte-monocyte ratio (LMR) was determined by dividing the absolute lymphocyte count on the absolute monocyte count. The minimum duration of follow-up after the last cycle of chemotherapy was not less than 36 months.
Results
In the population of patients (n = 124), 74% (n = 92) patients achieved and maintained a remission status within 36 months - favorable group. 26% (n = 32) of patients did not achieve remission after induction chemotherapy or developed a relapse within 36 months - unfavorable group. In an unfavorable group, 21 patients (64%) had an LMR level less than 2, while in a favorable group in 14 patients (20%) the LMR level was below 2 and 76 patients (80%) had LMR levels in the range 2-5. The disease-free survival (DFS) during 3 years in patients with 3-4 and 4-5 LMR was 92% and only 35% and 61% in groups with LMI <1 and 1-2 respectively (p = 0.038 log rank test). Using the ROC curve, the LMR-1.8 threshold level was determined which had the maximum effect on disease-free survival. With 74% specificity and 54% sensitivity, the ROC curve area was 0.73. Multivariate analysis using the Cox proportional hazard model with the inclusion of decrees level of LMR <2, age 45 and older, B-symptoms, IV stage, anemia, decreased serum albumin, increased LDH, leukocytosis, lymphocytopenia revealed that the decreased of level LMR <2 was an independent factor of poor prognosis (p = 0.028; RR=1,8, CI=0.4-5.2).
Conclusion
The decreased of level lymphocyte-monocyte ratio (LMR) <2 can be an independent prognostic factor of patients with classic lymphoma Hodgkin’s
Session topic: 17. Hodgkin lymphoma – Clinical
Keyword(s): Hodgkin's Lymphoma, Lymphocyte, monocyte, Prognostic factor