The Analysis Of Prognosis Relevance Of Absolute Lymphocyte Count、Absolute Monocyte Count And ALC/AMC Ratio In Diffuse Large B Cell Lymphoma Patients

Object:To analyze the prognostic factors of Diffuse large B-cell lymphoma(DLBCL)and to investigate the correlation between peripheral blood absolute lymphocyte count(ALC)、 peripheral blood absolute monocyte count(AMC)、 lymphocyte to monocyte Ratio(ALC/AMC)and prognosis of Diffuse large B-cell lymphoma(DLBCL).Method:In this paper,we retrospectively analyzed data from 291 DLBCL patients and100 healthy subjects.DLBCL patients were diagnosed as Diffuse large B-cell lymphoma(DLBCL)by pathology from January 2008 to December 2016.Putting the clinical parameters such as age、sex、Ann Arbor stage 、the number of extranodal sites of disease 、 lactate dehydrogenase(LDH)、 B symptoms 、 Eastern Cooperative Oncology Group performance status 、origin of cell 、the international prognostic index(IPI)、the peripheral blood absolute lymphocyte count(ALC)、the peripheral blood absolute monocyte count(AMC)、ALC/AMC and so on into this study,and applying analytical methods like T test,Chi-square test,Kaplan-Meier,Cox to test the relationship between the above indications and 5 years overall survival(OS)、5 year progression-free survival(PFS).Result:1.The result of overall mean of ALC、AMC、ALC/AMC ratio in test group and control group by T test suggested,the overall mean of ALC has no statistically significant(P=0.65).But overall mean of AMC and ALC/AMC ratio has statistically significant(P<0.001vsP=0.0014).2.The relationship between peripheral blood ALC,AMC and lymphocyte to monocyte Ratio and other prognostic factors that may affect DLBCL were shown in Table 4 for the first diagnosis of 291 patients included in this study.Patients with AMC≥0.5×109/L had a high incidence of advanced age>60 years old,Ann ArborIII-IV stage,B symptoms,IPI score≥3 and LDH level higher than normal,.Similar results were observed in patients with ALC<1.0×109/L and LMR<1.85.3.All 291 patients,after media 42 months follow,the 5-year overall survival(OS)rate is 81%,5-year progression free survival(PFS)rate is 57%.K-M analysis showed that lower ALC and LMR、 higher AMC associated with shorter overall survival(OS)(P<0.021 vs P<0.001 vs P<0.001).But in PFS set,ALC、AMC and LMR seemed to have no statistically significant(P=0.161 vs P=0.097vsP=0.252).4.In multivariate analysis,age 、IPI、ECOG 、AMC were closely associated with OS.Only AMC could be used as an independent prognosis factor of survival in peripheral blood routie examination(P<0.05).Conclusion:There are many domestic and foreign studies have shown that Age、B symptom、the number of extranodal sites of disease 、 Eastern Cooperative Oncology Group performance status、LDH、Ann Arbor stage、IPI、ALC 、AMC 、ALC/AMC can influence the prognosis of Diffuse large B-cell lymphoma(DLBCL).Multivariate analysis suggested that age、IPI 、ECOG 、AMC were still associated with OS and PFS.Peripheral blood AMC can be used as one of the independent prognostic factors of DLBCL,and can divide people who have very poor prognosis.