Absolute Lymphocyte/Monocyte Ratio at Diagnosis and Interim Positron-Emission Tomography Predict Survival in Classical Hodgkin Lymphoma

Abstract

Interim Positron-Emission Tomography (int-PET) and the peripheral blood absolute lymphocyte/monocyte ratio at di - agnosis (ALC/AMC-DX) have been shown to be predictors for progression-free survival (PFS) and time to progression (TTP) in classical Hodgkin lymphoma (cHL). Therefore, we studied if the combination of ALC/AMC-DX and the (int-PET) can further stratified PFS and TTP in cHL patients. Patients were required to be diagnosed, treated, and fol lowed with int-PET at Mayo Clinic, Rochester, Minnesota. From 2000 until 2008, 111 cHL patients qualified for the study. The median follow-up was 2.8 years (range: 0.3 - 10.4 years). Patients with a negative int-PET (N = 98) pre - sented with a higher ALC/AMC-DX (median of 2.32, range: 0.26 - 37.5) compared with patients with a positive int-PET (N = 13) (median of 0.9, range: 0.29 - 3.10), p < 0.004. By multivariate analysis, ALC/AMC-DX and the int-PET were independent predictors for PFS and TTP, when compared with the International prognostic Score. Patients were stratified into four groups: group 1 included patients with a negative int-PET and ALC/AMC-DX ≥ 1.1; group 2 included positive int-PET and ALC/AMC-DX ≥ 1.1; group 3 included negative int-PET and ALC/AMC-DX < 1.1; and group 4 included positive int-PET and ALC/AMC-DX < 1.1. Group 1 experienced superior PFS and TTP in compari son with the other groups. In conclusion, the combination of ALC/AMC-DX and the int-PET provides a simple model to assess clinical outcomes in cHL.