The significance of peripheral blood lymphocyte/monocyte ratio during follow-up of patients with diffuse large B-cell lymphoma
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摘要: 目的: 探讨淋巴细胞单核细胞比值(LMR)在弥漫大B细胞淋巴瘤(DLBCL)随访中的作用。方法: 2005-2015年在我院对130例原发性DLBCL患者进行一线化疗,并随访观察。结果: 130例患者中有40例(30.8%)在随访时复发,中位复发时间为12.5(1~101)个月。复发时LMR的最佳界值为2.8,其曲线下面积为0.804(P=0.001)。LMR<2.8的患者复发率较LMR ≥ 2.8的患者明显升高,其1年内的复发率分别为26.8%和10.1%(P=0.019);2年内的复发率分别为41.5%和14.6%(P=0.001);5年内的复发率分别为51.2%和18.0%(P=0.000)。多因素分析发现随访时LMR和LDH与复发相关,相关系数分别为2.546和2.708。低LMR值与较短总生存期及无进展期生存有关,LMR<2.8提示不良的预后(总生存期:P=0.000;无进展生存期:P=0.000)。结论: LMR可以作为DLBCL一线化疗后的随访指标,LMR降低提示复发可能。
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关键词:
- 淋巴细胞单核细胞比值 /
- 弥漫大B细胞淋巴瘤 /
- 随访 /
- 预后
Abstract: Objective: To study the role of the lymphocyte/monocyte ratio (LMR) as a marker during the follow-up of post standard first-line chemotherapy in patients with diffuse large B-cell lymphoma (DLBCL).Method: A total of 130 consecutive DLBCL patients,who originally diagnosed,treated with R-COP or R-CHOP and followed up between 2005 and 2015 in our hospital,were enrolled.LMR was obtained at the time of confirmed relapse or last follow-up.Result: Forty (30.8%) patients relapsed during follow up periods,and the median relapse time was 12.5 (range 1 to 101) months.The best cutoff of LMR as a predictor index for early relapse was 2.8,with an area under the curve 0.804 (P=0.001).Patients with LMR<2.8 had a higher relapse rate compared with LMR ≥ 2.8,relapse rate in 1 year was 26.8% vs.10.1% (P=0.019),in 2 year was 41.5% vs.14.6% (P=0.001),in 5 year was 51.2% vs.18.0% (P=0.000).Lower LMR and elevated LDH during follow-up period were significantly associated with relapse by multivariate analysis (HR=2.546 and 2.708 respectively).Low LMR was associated with shorter overall survival and progression-free survival,and LMR<2.8 means poorer prognosis (overall survival:P=0.000;progression-free survival:P=0.000).Conclusion: LMR can be used as a marker to assess the risk of DLBCL relapse during routine follow-up after standard first-line chemotherapy.-
Key words:
- lymphocyte/monocyte ratio /
- diffuse large B cell lymphoma /
- follow-up /
- prognosis
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[1] Lin B,Chen C,Qian Y,et al.Prognostic role of peripheral blood lymphocyte/monocyte ratio at diagnosis in diffuse large B-cell lymphoma:a meta-analysis[J].Leuk Lymphoma,2015,56:2563-2568.
[2] Weeks JC,Yeap BY,Canellos GP,et al.Value of follow-up procedures in patients with large-cell lymphoma who achieve a complete remission[J].J Clin Oncol,1991,9:1196-1203.
[3] Cheson BD,Pfistner B,Juweid ME,et al.Revised response criteria for malignant lymphoma[J].J Clin Oncol,2007,25:579-586.
[4] Aoki T,Nishiyama T,Imahashi N,et al.Lymphopenia following the completion of first-line therapy predicts early relapse in patients with diffuse large B cell lymphoma[J].Ann Hematol,2012,91:375-382.
[5] Tadmor T,Bari A,Sacchi S,et al.Monocyte count at diagnosis is a prognostic parameter in diffuse large B-cell lymphoma:results from a large multicenter study involving 1 191 patients in the pre-and post-rituximab era[J].Haematologica,2014,99:125-130.
[6] Li YL,Pan YY,Jiao Y,et al.Peripheral blood lymphocyte/monocyte ratio predicts outcome for patients with diffuse large B cell lymphoma after standard first-line regimens[J].Ann Hematol,2014,93:617-626.
[7] Yan-Li L,Kang-Sheng G,Yue-Yin P,et al.The lower peripheral blood lymphocyte/monocyte ratio assessed during routine follow-up after standard first-line chemotherapy is a risk factor for predicting relapse in patients with diffuse large B-cell lymphoma[J].Leuk Res,2014,38:323-328.
[8] Porrata LF,Ristow KM,Habermann TM,et al.Peripheral blood absolute lymphocyte/monocyte ratio during rituximab,cyclophosphamide,doxorubicin,vincristine and prednisone treatment cycles predicts clinical outcomes in diffuse large B-cell lymphoma[J].Leuk Lymphoma,2014,55:2728-2738.
[9] Cheson BD,Pfistner B,Juweid ME,et al.Revised response criteria for malignant lymphoma[J].J Clin Oncol,2007,25:579-586.
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