The Predictive Value of the Peripheral Blood Lymphocyte-to-Monocyte Ratio in Patients with Anaplastic Large Cell Lymphoma

Abstract BackgroundTo assess the value of the peripheral blood lymphocyte-to-monocyte ratio (LMR) in predicting the early treatment response and prognosis in patients with anaplastic large cell lymphoma (ALCL).MethodsThe optimal cut-off value for the LMR was determined using the receiver operating characteristic curve (ROC) method. The LMR was monitored dynamically, and the relationship between the LMR and therapeutic response, and survival was analyzed.Results The cumulative complete remission (CCR) rate was 57.1% in patients with low baseline LMR, remarkably lower than that for patients with high baseline LMR (80.0%) (P = 0.019). The 5-year overall survival (OS) and progression-free survival (PFS) were 51.3% and 32.6%, respectively, in the low baseline LMR group, which were significantly poorer at 90.4% and 70.5% in the high baseline LMR group, respectively (P values were 0.006 and 0.013, respectively). Furthermore, the median OS and PFS of patients with a decreased LMR after treatment were shorter than those with an elevated LMR after treatment (all P values < 0.05). Univariate and multivariate analysis demonstrated that low baseline LMR is an independent indicator for poor prognosis in ALCL patients (P values were 0.006 and 0.020, respectively). Interestingly, the combination of low baseline LMR and ALK positive could strongly predict the good prognosis in patients with ALCL. ConclusionsThe low baseline LMR and a decreased LMR after treatment are prognostic indicator for poor PFS and OS. The combination of LMR and ALK expression can widely risk-stratify patients for treatment and survival in patients with ALCL.