Prognostic Significance of the Ratio of Absolute Neutrophil Count to Absolute Lymphocyte Count in Classic Hodgkin Lymphoma

ArticleinAmerican Journal of Clinical Pathology 138(6):846-54 · December 2012with121 Reads
Impact Factor: 2.51 · DOI: 10.1309/AJCPO46GFKGNXCBR · Source: PubMed
Abstract

The aim of this study was to determine the prognostic effect of the absolute neutrophil count/absolute lymphocyte count ratio (ANC/ALC ratio) in patients with classic Hodgkin lymphoma (cHL). We performed a retrospective analysis of 312 patients with cHL. Univariate analysis revealed that a high ANC/ALC ratio (≥4.3) correlated with poor overall survival (OS) (P < .001). Subgroup analysis of advanced-stage disease showed that the ANC/ALC ratio was significant for OS (P = .032). Multivariate analysis revealed the ANC/ALC ratio to be an independent prognostic factor for OS (P = .048). The ANC/ALC ratio allowed further risk stratification in patients who were considered to be at low risk on the basis of an International Prognostic Score less than 4 (P = .002). The ANC/ALC ratio is a simple, inexpensive, and independent prognostic factor for OS that may improve the ability to identify high-risk patients with cHL.

    • "ROC curve of OS as a function of serum í µí»½ 2 -m concentration was generated to determine the optimum cutoff value of the latter [13]. The area under the curve was recorded 0.71 (95% confidence interval [CI], 0.592–0.827; "
    [Show abstract] [Hide abstract] ABSTRACT: Objective . To determine the prognostic significance of beta2 microglobulin ( β 2 -m) concentrations in patients with hemophagocytic lymphohistiocytosis (HLH), a rare disorder caused by pathologic activation of the immune system. Patients and Methods . The study population consisted of 74 patients diagnosed with HLH and 35 healthy controls. Serum β 2 -m levels were measured using a latex agglutination photometric immunoassay. Results . Median serum β 2 -m levels were significantly higher in HLH patients than in healthy controls (4.05 versus 1.5 mg/L; P < 0.001 ) and were significantly higher in patients with lymphoma associated hemophagocytic syndrome (LAHS) than in patients with benign disease-associated HLH (4.2 versus 3.3 mg/L; P < 0.001 ). Higher serum β 2 -m levels were positively correlated with LAHS ( P = 0.005 ), abnormal lactate dehydrogenase concentrations ( P = 0.009 ), and hypoalbuminemia ( P = 0.003 ). ROC analysis showed that overall survival (OS) was significantly shorter in LAHS patients with serum β 2 -m levels ≥4.03 mg/L compared to
    Full-text · Article · Mar 2016 · Disease markers
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    • "It has been found to be an independent prognostic factor for overall survival in adult cHL in two recent studies [17,18] but it was not confirmed in another analysis [19]. An elevated ANC has also been proposed to facilitate neoplasm growth [20], and an ANC/ALC ratio >4.3 has been proposed as an adverse prognostic factor in adult cHL [21]. Blood and tissue eosinophilia have been noted in about 15% [22] and 38% of HL patients [23], respectively. "
    [Show abstract] [Hide abstract] ABSTRACT: Background: Many biological and inflammatory markers have been proposed as having a prognostic value at diagnosis of Hodgkin lymphoma (HL), but very few have been validated in paediatric patients. We explored the significance of these markers in a large population of 769 affected children. Patients and methods: By using the database of patients enrolled in A.I.E.O.P. (Associazione Italiana di Emato-Oncologia Pediatrica) trial LH2004 for paediatric HL, we identified 769 consecutive patients treated with curative intent from 1st June 2004 to 1st April 2014 with ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine), or hybrid COPP/ABV (cyclophosphamide, vincristine, prednisone, procarbazine, doxorubicin, bleomycin and vinblastine) regimens. Results: On multivariate analysis with categorical forms, the 5-year freedom from progression survival was significantly lower in patients with stage IV or elevated value of platelets, eosinophils and ferritin at diagnosis. Furthermore, stage IV and eosinophils seem to maintain their predictive value independently of interim (after IV cycles of chemotherapy) positron emission tomography. Conclusion: Using the combination of four simple markers such as stage IV and elevated levels of platelets, ferritin and eosinophils, it is possible to classify the patients into subgroups with very different outcomes.
    Full-text · Article · Jan 2016 · European journal of cancer (Oxford, England: 1990)
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    • "NLR is a novel, inexpensive and easily applicable marker that shows inflammation. Studies showing association of NLR with coronary artery diseases such as acute coronary syndrome, stable CAD, and other diseases such as; malignancies, chronic renal impairment, Alzheimer's disease, metabolic syndrome , coronary artery ectasia are available in lit- erature4567891011121314 . Association between NLR and cardiovascular mortality and morbidity has been stated previously in some studies1516. "
    [Show abstract] [Hide abstract] ABSTRACT: Objective: Neutrophil/lymphocyte ratio (NLR) is a new, inexpensive and easily applicable indicator and one of the markers showing inflammation that plays an important role in the pathogenesis of coronary artery disease (CAD). There is currently no data showing the association between NLR and CAD in geriatric patients. Herein, we aimed to determine this relationship in this study. Materials and Methods: This is a cross-sectional study involving 507 patients of whom 239 were diagnosed with CAD while 268 were not. The patients’ demographic characteristics, illnesses, laboratory parameters and NLRs at the time of admission were investigated. Results: Mean age, gender rate, and comorbidities of the patients were similar between two groups. NLR was higher in patients with CAD than controls (2.34 vs. 2.03, p=0.003, respectively). Receiver operating characteristic (ROC) curve analysis suggested that optimum NLR cut-off point for CAD was 1.96 with 66.5% sensitivity and 48.8% specificity, 54.1% positive predictive values and 61.7% negative predictive values (AUC=0.575). Multivariate regression analysis revealed that NLR (OR: 1.208, 95% CI: 1.008–1.447, p = 0.041) and cigarette smoking (OR: 2.281, 95% CI: 1.037–5.019, p=0.040) were independently correlated with CAD. Conclusion: It has been shown that geriatric patients with CAD have higher NLR, and this new marker may be an independent correlate for CAD in geriatric patients.
    Full-text · Article · Dec 2015 · Acta medica
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