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Lymphoma

The absolute monocyte and lymphocyte prognostic score predicts survival and identifies high-risk patients in diffuse large-B-cell lymphoma

Leukemia volume 25, pages 1502–1509 (2011)Cite this article

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Abstract

Despite the use of modern immunochemotherapy regimens, almost 50% of patients with diffuse large-B-cell lymphoma will relapse. Current prognostic models, including the International Prognostic Index, incorporate patient and tumor characteristics. In contrast, recent observations show that variables related to host adaptive immunity and the tumor microenvironment are significant prognostic variables in non-Hodgkin lymphoma. Therefore, we retrospectively examined the absolute monocyte and lymphocyte counts as prognostic variables in a cohort of 366 diffuse large-B-cell lymphoma patients who were treated between 1993 and 2007 and followed at a single institution. The absolute monocyte and lymphocyte counts in univariate analysis predicted progression-free and overall survival when analyzed as continuous and dichotomized variables. On multivariate analysis performed with factors included in the IPI, the absolute monocyte and lymphocyte counts remained independent predictors of progression-free and overall survival. Therefore, the absolute monocyte and lymphocyte counts were combined to generate a prognostic score that identified patients with an especially poor overall survival. This prognostic score was independent of the IPI and added to its ability to identify high-risk patients.

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Authors and Affiliations

  1. Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN, USA

    R A Wilcox, K Ristow, T M Habermann, D J Inwards, I N M Micallef, P B Johnston, J P Colgan, G S Nowakowski, S M Ansell, T E Witzig, S N Markovic & L Porrata

  2. Department of Medical Oncology, Mayo Clinic, Rochester, MN, USA

    R A Wilcox & S N Markovic

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  1. R A Wilcox
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Correspondence to R A Wilcox.

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RAW designed study, performed research, analyzed data and wrote the manuscript; KR performed research, provided technical assistance and reviewed the manuscript; TMH, DJI, INMM, PBJ, JPC, GSN, SMA, TEW and SNM assisted with data analysis and manuscript preparation; LP assisted with study design, data analysis and manuscript preparation.

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Wilcox, R., Ristow, K., Habermann, T. et al. The absolute monocyte and lymphocyte prognostic score predicts survival and identifies high-risk patients in diffuse large-B-cell lymphoma. Leukemia 25, 1502–1509 (2011). https://doi.org/10.1038/leu.2011.112

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