Peripheral blood absolute lymphocyte/monocyte ratio during rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone treatment cycles predicts clinical outcomes in diffuse large B-cell 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

doi:10.3109/10428194.2014.893313

Peripheral blood absolute lymphocyte/monocyte ratio during rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone treatment cycles predicts clinical outcomes in diffuse large B-cell 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

Hematology

Research output: Contribution to journal › Article › peer-review

42 Scopus citations

Abstract

A limitation of the prognostic factor peripheral blood absolute lymphocyte/monocyte ratio (ALC/AMC) at diagnosis in diffuse large B-cell lymphoma (DLBCL) is its inability to sequentially assess the host/tumor microenvironment interaction and clinical outcomes during treatment. Therefore, we studied the ALC/AMC ratio at each rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) cycle as a predictor for survival. We studied 107 consecutive patients with DLBCL diagnosed, treated only with R-CHOP and followed at the Mayo Clinic. Unsupervised hierarchical clustering identified four clusters based on the patterns of ALC/AMC ratio recovery during cycles. The most inferior survival was seen in the cluster with ALC/AMC ratio < 1.1 in all cycles. By multivariate analysis, ALC/AMC ratio < 1.1 during all cycles was an independent predictor for inferior overall survival and progression-free survival. The ALC/AMC ratio during R-CHOP cycles predicts survival and provides a platform to develop therapeutic modalities to manipulate the ALC/AMC ratio during R-CHOP cycles to improve DLBCL clinical outcomes.

Original language	English (US)
Pages (from-to)	2728-2738
Number of pages	11
Journal	Leukemia and Lymphoma
Volume	55
Issue number	12
DOIs	https://doi.org/10.3109/10428194.2014.893313
State	Published - Dec 1 2014

Keywords

Lymphocytes
Lymphoma and Hodgkin disease
Monocytes

ASJC Scopus subject areas

Hematology
Oncology
Cancer Research

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Porrata, L. F., Ristow, K. M., Habermann, T. M., Witzig, T. E., Colgan, J. P., Inwards, D. J., Ansell, S. M., Micallef, I. N., Johnston, P. B., Nowakowski, G., Thompson, C. A., & Markovic, S. N. (2014). Peripheral blood absolute lymphocyte/monocyte ratio during rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone treatment cycles predicts clinical outcomes in diffuse large B-cell lymphoma. Leukemia and Lymphoma, 55(12), 2728-2738. https://doi.org/10.3109/10428194.2014.893313

Peripheral blood absolute lymphocyte/monocyte ratio during rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone treatment cycles predicts clinical outcomes in diffuse large B-cell lymphoma. / Porrata, Luis F.; Ristow, Kay M.; Habermann, Thomas M. et al.
In: Leukemia and Lymphoma, Vol. 55, No. 12, 01.12.2014, p. 2728-2738.

Research output: Contribution to journal › Article › peer-review

Porrata, LF, Ristow, KM, Habermann, TM , Witzig, TE, Colgan, JP, Inwards, DJ, Ansell, SM , Micallef, IN , Johnston, PB , Nowakowski, G , Thompson, CA & Markovic, SN 2014, 'Peripheral blood absolute lymphocyte/monocyte ratio during rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone treatment cycles predicts clinical outcomes in diffuse large B-cell lymphoma', Leukemia and Lymphoma, vol. 55, no. 12, pp. 2728-2738. https://doi.org/10.3109/10428194.2014.893313

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title = "Peripheral blood absolute lymphocyte/monocyte ratio during rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone treatment cycles predicts clinical outcomes in diffuse large B-cell lymphoma",

abstract = "A limitation of the prognostic factor peripheral blood absolute lymphocyte/monocyte ratio (ALC/AMC) at diagnosis in diffuse large B-cell lymphoma (DLBCL) is its inability to sequentially assess the host/tumor microenvironment interaction and clinical outcomes during treatment. Therefore, we studied the ALC/AMC ratio at each rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) cycle as a predictor for survival. We studied 107 consecutive patients with DLBCL diagnosed, treated only with R-CHOP and followed at the Mayo Clinic. Unsupervised hierarchical clustering identified four clusters based on the patterns of ALC/AMC ratio recovery during cycles. The most inferior survival was seen in the cluster with ALC/AMC ratio < 1.1 in all cycles. By multivariate analysis, ALC/AMC ratio < 1.1 during all cycles was an independent predictor for inferior overall survival and progression-free survival. The ALC/AMC ratio during R-CHOP cycles predicts survival and provides a platform to develop therapeutic modalities to manipulate the ALC/AMC ratio during R-CHOP cycles to improve DLBCL clinical outcomes.",

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AU - Habermann, Thomas M.

AU - Witzig, Thomas E.

AU - Colgan, Joseph P.

AU - Inwards, David J.

AU - Ansell, Stephen M.

AU - Micallef, Ivana N.

AU - Johnston, Patrick B.

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AB - A limitation of the prognostic factor peripheral blood absolute lymphocyte/monocyte ratio (ALC/AMC) at diagnosis in diffuse large B-cell lymphoma (DLBCL) is its inability to sequentially assess the host/tumor microenvironment interaction and clinical outcomes during treatment. Therefore, we studied the ALC/AMC ratio at each rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) cycle as a predictor for survival. We studied 107 consecutive patients with DLBCL diagnosed, treated only with R-CHOP and followed at the Mayo Clinic. Unsupervised hierarchical clustering identified four clusters based on the patterns of ALC/AMC ratio recovery during cycles. The most inferior survival was seen in the cluster with ALC/AMC ratio < 1.1 in all cycles. By multivariate analysis, ALC/AMC ratio < 1.1 during all cycles was an independent predictor for inferior overall survival and progression-free survival. The ALC/AMC ratio during R-CHOP cycles predicts survival and provides a platform to develop therapeutic modalities to manipulate the ALC/AMC ratio during R-CHOP cycles to improve DLBCL clinical outcomes.

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Peripheral blood absolute lymphocyte/monocyte ratio during rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone treatment cycles predicts clinical outcomes in diffuse large B-cell lymphoma

Abstract

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