The absolute monocyte and lymphocyte prognostic index for patients with diffuse large B-cell lymphoma who receive R-CHOP.
The absolute monocyte and lymphocyte prognostic index for patients with diffuse large B-cell lymphoma who receive R-CHOP.
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DOI：
10.1016/j.clml.2012.09.009
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发表时间：
2013-02
期刊：
影响因子：
--
通讯作者：
Hagemeister FB Jr
中科院分区：
文献类型：
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作者：
Batty N;Ghonimi E;Feng L;Fayad L;Younes A;Rodriguez MA;Romaguera JE;McLaughlin P;Samaniego F;Kwak LW;Hagemeister FB Jr
基于初始绝对淋巴细胞和单核细胞计数的指数可以提供关于接受R-CHOP化疗的未经治疗的弥漫性大细胞淋巴瘤患者管理中的国际预后因素指数以外的预后信息。基线单核细胞绝对计数和淋巴细胞绝对计数用于生成弥漫性大B细胞淋巴瘤（DLBCL）生存的预后指数（AMLPI）。回顾了245例接受标准R-CHOP（利妥昔单抗、环磷酰胺、盐酸多柔比星、硫酸长春新碱、泼尼松）治疗的DLBCL患者的数据。通过使用先前报道的AMLPI值，在我们的人群中检查其预后价值。经过22个月的中位随访，国际预后指数（IPI）0-2和3-5风险组的3年无进展生存率（PFS）分别为73%和58%（P = .0004）;可比的总生存率（OS）分别为88%和68%（P < .0001）。对于IPI评分为0-2的患者，AMLPI低、中和高风险组的1年PFS率分别为92%、89%和80%（P = 0.022）;相似的1年OS率分别为96%、95%和80%（P = 0.049）。通过多变量分析，在模型中调整IPI后，AMLPI对PFS和OS率的影响（低风险组与高风险组）具有显著性，分别为P = 0.046（风险比[HR] 0.402 [95% CI，0.164-0.986]和P = 0.052（HR 0.325 [95% CI，0.104-1.011]）。对于接受R-CHOP的DLBCL患者，绝对单核细胞和淋巴细胞计数预后指数（AMLPI）可能会增加超过IPI的预后价值。
An index based on the initial absolute lymphocyte and monocyte counts may provide prognostic information regarding outcome beyond that of the International Prognostic Factors Index in management of patients with untreated diffuse large cell lymphoma who are receiving R-CHOP chemotherapy. The baseline absolute monocyte count and absolute lymphocyte count were used to generate a prognostic index (the AMLPI) for survival in diffuse large B-cell lymphoma (DLBCL). Data from 245 patients with DLBCL who were treated with standard R-CHOP (rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, prednisone) were reviewed. By using the values previously reported for the AMLPI, its prognostic value was examined in our population. After a median follow-up of 22 months for censored observations, the 3-year progression-free survival (PFS) rates for the international prognostic index (IPI) 0–2 and 3–5 risk groups were 73% and 58%, respectively (P = .0004); comparable overall survival (OS) rates were 88% and 68%, respectively (P < .0001). For patients with IPI scores of 0–2, 1-year PFS rates for AMLPI low-, intermediate-, and high-risk groups were 92%, 89%, and 80%, respectively (P = .022); comparable 1-year OS rates were 96%, 95%, and 80%, respectively (P = .049). By multivariate analysis, with the adjustment of IPI in the model, AMLPI effects (low- vs. high-risk groups) on PFS and OS rates were significant, with P = .046 (hazard ratio [HR] 0.402 [95% CI, 0.164–0.986] and P = .052 (HR 0.325 [95% CI, 0.104–1.011]), respectively. The absolute monocyte and lymphocyte counts prognostic index (the AMLPI) may add prognostic value beyond that of the IPI for patients with DLBCL who receive R-CHOP.