Absolute Lymphocyte/Monocyte Ratio at Diagnosis and Interim Positron-Emission Tomography Predict Survival in Classical Hodgkin Lymphoma

Luis F. Porrata, Kay M. Ristow, Thomas M. Habermann, Thomas E. Witzig, Joseph P. Colgan, David J. Inwards, Stephen M. Ansell, Ivana N. Micallef, Patrick B. Johnston, Grzegorz Nowakowski, Carrie A. Thompson, Svetomir N. Markovic

Division of Hematology, Internal Medicine, Mayo College of Medicine, Rochester, USA.

DOI: 10.4236/jct.2013.43A055                

Abstract

Interim Positron-Emission Tomography (int-PET) and the peripheral blood absolute lymphocyte/monocyte ratio at di- agnosis (ALC/AMC-DX) have been shown to be predictors for progression-free survival (PFS) and time to progression (TTP) in classical Hodgkin lymphoma (cHL). Therefore, we studied if the combination of ALC/AMC-DX and the (int-PET) can further stratified PFS and TTP in cHL patients. Patients were required to be diagnosed, treated, and followed with int-PET at Mayo Clinic, Rochester, Minnesota. From 2000 until 2008, 111 cHL patients qualified for the study. The median follow-up was 2.8 years (range: 0.3 - 10.4 years). Patients with a negative int-PET (N = 98) pre- sented with a higher ALC/AMC-DX (median of 2.32, range: 0.26 - 37.5) compared with patients with a positive int-PET (N = 13) (median of 0.9, range: 0.29 - 3.10), p < 0.004. By multivariate analysis, ALC/AMC-DX and the int-PET were independent predictors for PFS and TTP, when compared with the International prognostic Score. Patients were stratified into four groups: group 1 included patients with a negative int-PET and ALC/AMC-DX ≥ 1.1; group 2 included positive int-PET and ALC/AMC-DX ≥ 1.1; group 3 included negative int-PET and ALC/AMC-DX < 1.1; and group 4 included positive int-PET and ALC/AMC-DX < 1.1. Group 1 experienced superior PFS and TTP in comparison with the other groups. In conclusion, the combination of ALC/AMC-DX and the int-PET provides a simple model to assess clinical outcomes in cHL.

Keywords

Classical Hodgkin Lymphoma; Absolute Lymphocyte/Monocyte Ratio at Diagnosis; Interim PET-Scan; Progression-Free Survival; Time to Progression

Conflicts of Interest

The authors declare no conflicts of interest.

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