Classical Hodgkin Lymphoma: Lymphocyte/monocyte ratio and survival

http://www.ncbi.nlm.nih.gov/pubmed/21993683

Haematologica. 2011 Oct 11. [Epub ahead of print]
Peripheral blood lymphocyte/monocyte ratio at diagnosis and survival in classical Hodgkin lymphoma.
Porrata LF, Ristow K, Colgan J, Habermann T, Witzig T, Thompson C, Inwards D, Ansell S, Micallef I, Johnston P, Nowakowski G, Thompson C, Markovic S.

Abstract
Background. Lymphopenia and tumor-associated macrophages are negative prognostic factors for survival in classical Hodgkin's lymphoma. Thus, we studied if the peripheral blood absolute lymphocyte count/absolute monocyte count ratio at diagnosis affects survival in classical Hodgkin's lymphoma.Design and Methods. We studied 476 consecutive classical Hodgkin's lymphoma patients followed at Mayo Clinic from 1974 to 2010. Receiver operating characteristic and area under the curve were used for absolute lymphocyte count/absolute monocyte count ratio at diagnosis cut-off value analysis and proportional-hazards models were used to compare survival based on the absolute lymphocyte count/absolute monocyte count ratio at diagnosis ratio.Results. The median follow-up period was 5.6 years (range: 0.1-33.7 years). An absolute lymphocyte count/absolute monocyte count ratio at diagnosis ≥1.1 was the best cut-off value for survival with an area under the curve of 0.91 (95% confidence interval, 0.86 to 0.96), a sensitivity of 90% (95% confidence interval, 85% to 96%) and specificity of 79% (95% confidence interval, 73% to 88%). Absolute lymphocyte count/absolute monocyte count ratio at diagnosis was an independent prognostic factor for overall survival {hazard ratio , 0.18, 95% confidence interval, 0.08 to 0.38, p< 0.0001]; lymphoma-specific survival [hazard ratio, 0.10; 95% confidence interval, 0.04 to 0.25, p <0.0001]; progression-free survival [hazard ratio, 0.35; 95% confidence interval, 0.18 to 0.66, p < 0.002], and time to progression [hazard ratio, 0.27, 95% confidence interval, 0.17 to 0.57, p <0.0006]. Conclusions. Absolute lymphocyte count/absolute monocyte count ratio at diagnosis is an independent prognostic factor for survival and provides a single biomarker to predict clinical outcomes in classical Hodgkin's lymphoma.