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Infused autograft lymphocyte to monocyte ratio predicts survival in classical Hodgkin lymphoma.

Porrata LF, Inwards DJ, Ansell SM, Micallef IN, Johnston PB, Hogan WJ, Markovic SN - J Blood Med (2015)

Bottom Line: Patients with an A-LMR ≥1.0 experienced a superior overall survival (OS) versus patients with an A-LMR <1.0 (median OS not reached versus 40.4 months, 5-year OS rates of 86% [95% CI 72-93] versus 43% [95% CI 28-58], P<0.0001, respectively) in the training set.In the validation set, an A-LMR ≥1 showed a median OS of not reached versus 41.4 months for an A-LMR <1, 5-year OS rates of 90% (95% CI 73-97) versus 48% (95% CI 28-68; P<0.0001).A-LMR provides a platform to engineer an autograft versus tumor effect to improve clinical outcomes in patients with classical Hodgkin lymphoma undergoing APHSCT.

View Article: PubMed Central - PubMed

Affiliation: Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA.

ABSTRACT
The infused autograft lymphocyte to monocyte ratio (A-LMR) as a surrogate marker of host immunity (ie, absolute lymphocyte count) and CD14+ HLA-DR(low/neg) immunosuppressive monocytes (ie, absolute monocyte count) is a prognostic factor for patients with diffuse large B-cell lymphoma after autologous peripheral hematopoietic stem cell transplantation (APHSCT). Thus, we set out to investigate if A-LMR can also affect survival post-APHSCT in classical Hodgkin lymphoma. From 1994 to 2012, 183 patients with classical Hodgkin lymphoma who underwent APHSCT were studied. The patients were randomly divided into a training set (n=122) and a validation set (n=61). The receiver operating characteristic and area under the curve identified an A-LMR ≥1 as the best cut-off value and validated by the k-fold cross-validation in the training set. Multivariate analysis showed A-LMR to be an independent prognostic factor for survival in the training set. Patients with an A-LMR ≥1.0 experienced a superior overall survival (OS) versus patients with an A-LMR <1.0 (median OS not reached versus 40.4 months, 5-year OS rates of 86% [95% CI 72-93] versus 43% [95% CI 28-58], P<0.0001, respectively) in the training set. In the validation set, an A-LMR ≥1 showed a median OS of not reached versus 41.4 months for an A-LMR <1, 5-year OS rates of 90% (95% CI 73-97) versus 48% (95% CI 28-68; P<0.0001). A-LMR provides a platform to engineer an autograft versus tumor effect to improve clinical outcomes in patients with classical Hodgkin lymphoma undergoing APHSCT.

No MeSH data available.


Related in: MedlinePlus

Survival outcomes based on A-LMR. (A) Overall survival, (B) progression-free survival, (C) lymphoma-specific survival, and (D) time to progression. Validation set. (E) Overall survival, (F) progression-free survival, (G) lymphoma-specific survival, and (H) time to progression.Abbreviation: A-LMR, autograft lymphocyte/monocyte ratio.
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f1-jbm-6-045: Survival outcomes based on A-LMR. (A) Overall survival, (B) progression-free survival, (C) lymphoma-specific survival, and (D) time to progression. Validation set. (E) Overall survival, (F) progression-free survival, (G) lymphoma-specific survival, and (H) time to progression.Abbreviation: A-LMR, autograft lymphocyte/monocyte ratio.

Mentions: Using the cut-off value of 1.0 for the A-LMR obtained from the empiric ROC and subsequently validated by k-fold cross-validation in the training set, we tested A-LMR ≥1 for OS, PFS, LSS, and TTP. We observed that patients infused with an A-LMR ≥1 compared with patients infused with an A-LMR <1 experienced superior OS (Figure 1A), PFS (Figure 1B), LSS (Figure 1C), and TTP (Figure 1D) in the training set (median OS not reached versus 40.4 months, 5-year OS rates of 86% [95% CI 72–93] versus 43% [95% CI 28–58]), respectively, P<0.0001; median PFS not reached versus 8.4 months, 5-year PFS rates of 77% [95% CI 64–86] versus 20% [95% CI 10–35], respectively, P<0.0001; median LSS not reached versus 40.4 months, 5-year LSS rates of 94% [95% CI 83–98] versus 42% [95% CI 28–58], respectively, P<0.0001; and median TTP not reached versus 8.4 months, 5-year TTP rates of 86% [95% CI 74–93] versus 21% [95% CI 11–37], respectively, P<0.0001). The superior OS, PFS, LSS, and TTP observed in the training set with an A-LMR ≥1 versus the group with an A-LMR <1 were further validated in the validation set (median OS [Figure 1E] not reached versus 41.4 months, 5-year OS rates of 90% [95% CI 73–97] versus 48% [95% CI 73–97], respectively, P<0.0001; median PFS [Figure 1F] not reached versus 9.8 months, 5-year PFS rates of 75% [95% CI 57–87] versus 22% [95% CI 10–44], respectively, P<0.0001; median LSS [Figure 1G] not reached versus 41.8 months, 5-year LSS rates of 90% [95% CI 73–97] versus 50% [95% CI 30%–70%], respectively, P<0.0001; and median TTP [Figure 1H] not reached versus 10.5 months, 5-year TTP rates of 75% [95% CI 57–87] versus 24% [95% CI 11–45], respectively, P<0.0001).


Infused autograft lymphocyte to monocyte ratio predicts survival in classical Hodgkin lymphoma.

Porrata LF, Inwards DJ, Ansell SM, Micallef IN, Johnston PB, Hogan WJ, Markovic SN - J Blood Med (2015)

Survival outcomes based on A-LMR. (A) Overall survival, (B) progression-free survival, (C) lymphoma-specific survival, and (D) time to progression. Validation set. (E) Overall survival, (F) progression-free survival, (G) lymphoma-specific survival, and (H) time to progression.Abbreviation: A-LMR, autograft lymphocyte/monocyte ratio.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4321658&req=5

f1-jbm-6-045: Survival outcomes based on A-LMR. (A) Overall survival, (B) progression-free survival, (C) lymphoma-specific survival, and (D) time to progression. Validation set. (E) Overall survival, (F) progression-free survival, (G) lymphoma-specific survival, and (H) time to progression.Abbreviation: A-LMR, autograft lymphocyte/monocyte ratio.
Mentions: Using the cut-off value of 1.0 for the A-LMR obtained from the empiric ROC and subsequently validated by k-fold cross-validation in the training set, we tested A-LMR ≥1 for OS, PFS, LSS, and TTP. We observed that patients infused with an A-LMR ≥1 compared with patients infused with an A-LMR <1 experienced superior OS (Figure 1A), PFS (Figure 1B), LSS (Figure 1C), and TTP (Figure 1D) in the training set (median OS not reached versus 40.4 months, 5-year OS rates of 86% [95% CI 72–93] versus 43% [95% CI 28–58]), respectively, P<0.0001; median PFS not reached versus 8.4 months, 5-year PFS rates of 77% [95% CI 64–86] versus 20% [95% CI 10–35], respectively, P<0.0001; median LSS not reached versus 40.4 months, 5-year LSS rates of 94% [95% CI 83–98] versus 42% [95% CI 28–58], respectively, P<0.0001; and median TTP not reached versus 8.4 months, 5-year TTP rates of 86% [95% CI 74–93] versus 21% [95% CI 11–37], respectively, P<0.0001). The superior OS, PFS, LSS, and TTP observed in the training set with an A-LMR ≥1 versus the group with an A-LMR <1 were further validated in the validation set (median OS [Figure 1E] not reached versus 41.4 months, 5-year OS rates of 90% [95% CI 73–97] versus 48% [95% CI 73–97], respectively, P<0.0001; median PFS [Figure 1F] not reached versus 9.8 months, 5-year PFS rates of 75% [95% CI 57–87] versus 22% [95% CI 10–44], respectively, P<0.0001; median LSS [Figure 1G] not reached versus 41.8 months, 5-year LSS rates of 90% [95% CI 73–97] versus 50% [95% CI 30%–70%], respectively, P<0.0001; and median TTP [Figure 1H] not reached versus 10.5 months, 5-year TTP rates of 75% [95% CI 57–87] versus 24% [95% CI 11–45], respectively, P<0.0001).

Bottom Line: Patients with an A-LMR ≥1.0 experienced a superior overall survival (OS) versus patients with an A-LMR <1.0 (median OS not reached versus 40.4 months, 5-year OS rates of 86% [95% CI 72-93] versus 43% [95% CI 28-58], P<0.0001, respectively) in the training set.In the validation set, an A-LMR ≥1 showed a median OS of not reached versus 41.4 months for an A-LMR <1, 5-year OS rates of 90% (95% CI 73-97) versus 48% (95% CI 28-68; P<0.0001).A-LMR provides a platform to engineer an autograft versus tumor effect to improve clinical outcomes in patients with classical Hodgkin lymphoma undergoing APHSCT.

View Article: PubMed Central - PubMed

Affiliation: Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA.

ABSTRACT
The infused autograft lymphocyte to monocyte ratio (A-LMR) as a surrogate marker of host immunity (ie, absolute lymphocyte count) and CD14+ HLA-DR(low/neg) immunosuppressive monocytes (ie, absolute monocyte count) is a prognostic factor for patients with diffuse large B-cell lymphoma after autologous peripheral hematopoietic stem cell transplantation (APHSCT). Thus, we set out to investigate if A-LMR can also affect survival post-APHSCT in classical Hodgkin lymphoma. From 1994 to 2012, 183 patients with classical Hodgkin lymphoma who underwent APHSCT were studied. The patients were randomly divided into a training set (n=122) and a validation set (n=61). The receiver operating characteristic and area under the curve identified an A-LMR ≥1 as the best cut-off value and validated by the k-fold cross-validation in the training set. Multivariate analysis showed A-LMR to be an independent prognostic factor for survival in the training set. Patients with an A-LMR ≥1.0 experienced a superior overall survival (OS) versus patients with an A-LMR <1.0 (median OS not reached versus 40.4 months, 5-year OS rates of 86% [95% CI 72-93] versus 43% [95% CI 28-58], P<0.0001, respectively) in the training set. In the validation set, an A-LMR ≥1 showed a median OS of not reached versus 41.4 months for an A-LMR <1, 5-year OS rates of 90% (95% CI 73-97) versus 48% (95% CI 28-68; P<0.0001). A-LMR provides a platform to engineer an autograft versus tumor effect to improve clinical outcomes in patients with classical Hodgkin lymphoma undergoing APHSCT.

No MeSH data available.


Related in: MedlinePlus