Monocyte count at diagnosis is a prognostic parameter in diffuse large B-cell lymphoma: results from a large multicenter study involving 1191 patients in the pre- and post-rituximab era
Monocyte count at diagnosis is a prognostic parameter in diffuse large B-cell lymphoma: results from a large multicenter study involving 1191 patients in the pre- and post-rituximab era
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DOI：
10.3324/haematol.2013.088161
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发表时间：
2014-01-01
期刊：
影响因子：
10.1
通讯作者：
Polliack, Aaron
中科院分区：
文献类型：
--
作者：
Tadmor, Tamar;Bari, Alessia;Polliack, Aaron
在这项研究中，我们评估了单核细胞绝对计数的预后意义，并在一大群弥漫性大 B 细胞淋巴瘤患者中选择了诊断时的最佳临界值。检索了 1993 年至 2010 年期间在以色列和意大利接受治疗的弥漫性大 B 细胞淋巴瘤初治患者的数据。最终对 1017 名患者进行了分析，中位随访时间为 48 个月，5 年总生存率为 68%。最佳绝对单核细胞计数截止水平为 630/mm(3)，计数低于此截止值的患者的 5 年总生存率为 71%，而计数 >630 mm(3) 的患者为 59%（P=0.0002）。在 1017 名患者中，521 名 (51%) 接受了化学免疫治疗，在该队列中，使用多变量分析，即使根据国际预后指数进行调整，单核细胞计数升高仍保留负预后值 (HR1.54，P=0.009)。这项大型研究表明，诸如绝对单核细胞计数（>630/mm(3)）之类的简单参数可以很容易地常规用于评估新诊断的弥漫性大B细胞淋巴瘤，以识别利妥昔单抗时代生存较差的高危患者。
In this study we assessed the prognostic significance of absolute monocyte count and selected the best cut-off value at diagnosis in a large cohort of patients with diffuse large B-cell lymphoma. Data were retrieved for therapy-naive patients with diffuse large B-cell lymphoma followed in Israel and Italy during 1993-2010. A final cohort of 1017 patients was analyzed with a median follow up of 48 months and a 5-year overall survival rate of 68%. The best absolute monocyte count cut-off level was 630/mm(3) and the 5-year overall survival for patients with counts below this cut-off was 71%, whereas it was 59% for those with a count >630 mm(3) (P=0.0002). Of the 1017 patients, 521 (51%) were treated with chemo-immunotherapy, and in this cohort, using multivariate analysis, elevated monocyte count retained a negative prognostic value even when adjusted for International Prognostic Index (HR1.54, P=0.009). This large study shows that a simple parameter such as absolute monocyte count (>630/mm(3)) can easily be used routinely in the evaluation of newly diagnosed diffuse large B-cell lymphoma to identify high-risk patients with a worse survival in the rituximab era.