The Analysis Of Prognostic Significance Of Absolute Lymphocyte Count And Lymphocyte-to-Monocyte Ratio In Diffuse Large B-cell Lymphoma Patients

【Objective】This paper evaluate the prognostic value of absolute lymphocyte count (ALC)andlymphocyte-to-monocyte ratio (LMR) in Diffuse large B-cell lymphoma(DLBCL) whenthey are diagnosed.【Methods】Sixty-nine cases were analyzed retrospectively, including sex, age, stage, B symptoms,absolute lymphocyte count, lymphocyte-to-monocyte ratio, lactate dehydrogenase, IPIscore, bulky disease, ECOG performance status, number of extranodal involvement.Thirty-four received CHOP therapy treatment (cyclophosphamide, vincristine, adriamycin,dexamethasone), thirty-five received RCHOP (rituximab plus CHOP) therapy treatment.The ALC, AMC, LMR cutoff value for survival analysis determined by foreign papers was1.0×109/L,0.3×109/L,2.6. ALC and LMR, had tested by the χ2maybe have a relationshipwith DLBCL, performed Kaplan-Meier method, comparison between groups was usinglog-rank test. Multivariate analysis was carried out using Cox proportional hazard model.【Results】1.Patients with ALC<1.0×109/L had a high incidence of advanced Ann Arbor stage(P=0.003), B symptoms (P=0.001), elevated LDH level (P<0.001), high IPI score(P<0.001) and high ECOG score (P=0.001). Similar results were observed in patients withLMR<2.6. Patients with LMR<2.6had a high incidence of advanced Ann Arbor stage(P<0.001), B symptoms (P=0.005), elevated LDH level (P<0.001), high IPI score(P<0.001) and high ECOG score (P=0.006).2.In comparison with CHOP and RCHOP treatment, OS was significant longer withrituximab, as well as PFS(P＜0.05). 3.After media41.5months follow, K-M analysis showed that lower ALC and LMRassociated with inferior overall survival (OS) and progression free survival (PFS)(P＜0.001). In CHOP treatment set, patients with lower ALC and LMR seemed to have worseOS and PFS (ALC: P=0.002in OS,and P=0.005in PFS; LMR: P=0.011in OS, andP=0.027in PFS). We got the same results in RCHOP set (ALC: P=0.001in OS; P=0.001in PFS/LMR: P=0.001in OS; P=0.002in PFS).4.In multivariate analysis, only ALC were proven as an independent prognosis factorof survival(P<0.05).【Conclusions】At diagnosis, ALC is prognostic factor in DLBCL, Low ALC is an dangerous signalin DLBCL patients.