Korean J Pathol.  2013 Dec;47(6):526-533.

Prognostic Significance of Absolute Lymphocyte Count/Absolute Monocyte Count Ratio at Diagnosis in Patients with Multiple Myeloma

• Shin SJ
• Roh J
• Kim M
• Jung MJ
• Koh YW
• Park CS
• Yoon DH
• Suh C
• Park CJ
• Chi HS
• Huh J

Abstract

BACKGROUND
Absolute lymphocyte count (ALC) in peripheral blood has recently been reported to be an independent prognostic factor in multiple myeloma (MM). Previous studies indicated that the absolute monocyte count (AMC) in peripheral blood reflects the state of the tumor microenvironment in lymphomas. Neither the utility of the AMC nor its relationship with ALC has been studied in MM.
METHODS
The prognostic value of ALC, AMC, and the ALC/AMC ratio at the time of diagnosis was retrospectively examined in 189 patients with MM.
RESULTS
On univariate analysis, low ALC (<1,400 cells/microL), high AMC (> or =490 cells/microL), and low ALC/AMC ratio (<2.9) were correlated with worse overall survival (OS) (p=.002, p=.038, and p=.001, respectively). On multivariate analysis, the ALC/AMC ratio was an independent prognostic factor (p=.047), whereas ALC and AMC were no longer statistical significant. Low ALC, high AMC, and low ALC/AMC ratio were associated with poor prognostic factors such as high International Staging System stage, plasmablastic morphology, hypoalbuminemia, and high beta2-microglobulin.
CONCLUSIONS
Univariate analysis demonstrated that changes in ALC, AMC, and the ALC/AMC ratio are associated with patient survival in MM. Multivariate analysis showed that, of these factors, the ALC/AMC ratio was an independent prognostic factor for OS.

Keyword

Multiple myeloma; Lymphocytes; Monocytes; Lymphocyte/monocyte ratio; Prognosis

MeSH Terms

Diagnosis*
Humans
Hypoalbuminemia
Lymphocyte Count
Lymphocytes*
Lymphoma
Monocytes*
Multiple Myeloma*
Multivariate Analysis
Prognosis
Retrospective Studies
Tumor Microenvironment