Monocyte count at diagnosis is a prognostic parameter in diffuse large B-cell lymphoma: results from a large multicenter study involving 1191 patients in the pre- and post-rituximab era
Tamar Tadmor,
Alessia Bari,
Stefano Sacchi,
Luigi Marcheselli,
Eliana Valentina Liardo,
Irit Avivi,
Noam Benyamini,
Dina Attias,
Samantha Pozzi,
Maria Christina Cox,
Luca Baldini,
Maura Brugiatelli,
Massimo Federico,
Aaron Polliack
Affiliations
Tamar Tadmor
Hematology-Oncology Unit, Bnai Zion Medical Center, Haifa, Israel;The Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
Alessia Bari
Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
Stefano Sacchi
Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
Luigi Marcheselli
Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
Eliana Valentina Liardo
Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
Irit Avivi
Hematology & Bone Marrow Transplantation, Rambam Medical Center, Haifa, Israel;The Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
Noam Benyamini
Department of Hematology, AO Sant’Andrea, La Sapienza University, Rome, Italy
Dina Attias
Hematology-Oncology Unit, Bnai Zion Medical Center, Haifa, Israel;The Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
Samantha Pozzi
Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
Maria Christina Cox
Department of Hematology, AO Sant’Andrea, La Sapienza University, Rome, Italy
Luca Baldini
Division of Hematology, Fondazione IRCCS CàGranda, University of Milan, Milan, Italy
Maura Brugiatelli
Department of Hematology, Azienda Ospedaliera Papardo, Messina, Italy
Massimo Federico
Department of Diagnostic, Clinical, and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
Aaron Polliack
Department of Hematology, Hadassah University Hospital and Hebrew University Medical School, Jeruslaem, Israel
In this study we assessed the prognostic significance of absolute monocyte count and selected the best cut-off value at diagnosis in a large cohort of patients with diffuse large B-cell lymphoma. Data were retrieved for therapy-naïve patients with diffuse large B-cell lymphoma followed in Israel and Italy during 1993–2010. A final cohort of 1017 patients was analyzed with a median follow up of 48 months and a 5-year overall survival rate of 68%. The best absolute monocyte count cut-off level was 630/mm3 and the 5-year overall survival for patients with counts below this cut-off was 71%, whereas it was 59% for those with a count >630 mm3 (P=0.0002). Of the 1017 patients, 521 (51%) were treated with chemo-immunotherapy, and in this cohort, using multivariate analysis, elevated monocyte count retained a negative prognostic value even when adjusted for International Prognostic Index (HR1.54, P=0.009). This large study shows that a simple parameter such as absolute monocyte count (>630/mm3) can easily be used routinely in the evaluation of newly diagnosed diffuse large B-cell lymphoma to identify high-risk patients with a worse survival in the rituximab era.
