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Background and purpose: Natural killer/T-cell lymphoma (NKTCL) is a scarce subtype of malignant lymphoma, and it has heterogeneous clinical manifestation and treatment effect. Currently, no precise risk stratification is used to guide prognosis. This study aimed to evaluate the prognostic impact of pre-treatment peripheral blood absolute monocyte count (AMC) and platelet-lymphocyte ratio (PLR) in patients with primary nasal NKTCL, and provide more precise information for better risk stratification to select appropriate treatment and improve survival. Methods: Clinical data of 132 patients newly diagnosed with primary nasal NKTCL was collected in the Tianjin Medical University Cancer Institute and Hospital from Jan. 2008 to Dec. 2013. The relationship between AMC and PLR in pre-treatment peripheral blood and 5-year overall survival (OS) and progression-free survival (PFS) of patients was analyzed retrospectively. Independent prognostic factors of patients were determined by univariate analysis and Cox regression analysis. Results: Pre-treatment peripheral blood AMC and PLR play important roles in the prognosis stratification of patients with primary nasal NKTCL. The prognosis in patients of AMC<0.5×109/L were higher than those of AMC≥0.5×109/L, The prognosis in patients of PLR<150 were higher than those of PLR≥150 (P<0.05). Based on the four independent risk factors of staging, ECOG scoring, AMC and PLR, we tried to establish a new prognostic model, dividing all patients into three different risk groups and found that the 5-year OS and PFS of three groups had significant statistical differences. Conclusion: Peripheral blood AMC and PLR were significantly correlated with the prognosis of patients with primary nasal NKTCL. The new prognostic patterns based on the four independent risk factors, such as staging, ECOG scoring, AMC and PLR may be more convenient and more economical than IPI (International Prognostic Index, IPI) and KPI (Korean Prognostic Index, KPI).
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Background and purpose:The prognostic capability of traditional prognostic index like follicular lymphoma international prognostic index (FLIPI) is limited in the rituximab era. This study was to investigate the prognostic significance of peripheral blood absolute lymphocyte count/absolute monocyte count (ALC/AMC) in Chinese patients with follicular lymphoma (FL).Methods:This study retrospectively analyzed 136 newly diagnosed FL patients who received rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP)-like chemotherapy in Department of Hematology, Ruijin Hospital from Jan. 2003 to Dec. 2013, and further classified these patients according to FLIPI scoring system.Results:According to FLIPI, 61 patients (44.9%) were stratified into the low-risk (0-1 points) group, 42 cases (30.9%) into the intermediate-risk (2 points) group, and 33 cases (24.2%) into the high-risk (3-5 points) group. The overall response rate and 2-year progression-free survival (PFS) of the 3 risk groups were 88.5%, 95.2%, and 78.8% (P=0.090), and 91.4%, 74.6%, and 47.8% (log-rank=23.3,P<0.001), respectively. The overall response rate and 2-year PFS for patients with ALC/AMC≥4.7 and <4.7 were 91.9%, 68.6% (P=0.005) and 96.0%, 69.7% (log-rank=13.0,P<0.001), respectively. In the multivariate study, ALC/AMC≥4.7 was independent of FLIPI and was able to distinguish the FLIPI low-risk and intermediate-risk patients (log-rank=7.535,P=0.006).Conclusion:For FL patients treated with R-CHOP-like regimens, ALC/AMC is a simple and effective biomarker reflecting tumor microenvironment and human immunity, and could be considered for prognosis evaluation.
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PURPOSE: We evaluated the easily-assessable risk factors to predict bacteremia in children with febrile neutropenia, who received anticancer chemotherapy. METHODS: We retrospectively reviewed 46 children who had febrile neutropenia caused by anticancer chemotherapy between March, 1993 and February, 1997. The patients with localized infection on presentation were not eligible for this study. We evaluated the correlation between bacteremia and some variables, including absolute neutrophil count (ANC), absolute monocyte count (AMoC) and absolute phagocyte count (APC). RESULTS: There was total of 147 consecutive episodes of fever in 46 children, with 90 episodes of fever were noted in neutropenic patients without localized infection. There were 20 episodes of bacteremia (22.2%) in 90 episodes of febrile neutropenia. The mean ANC of 365.5 +/- 448.3/microliter, mean AMoC 132.3 +/- 310.4/microliter and mean APC 502.0 +/- 603.3/microliter did not show significant correlation with bacteremia. There was no statistically significant correlation between bacteremia and ANC or AMoC. There was higher risk of bacteremia in patients with AMoC less than 100/microliter as compared with patients with AMoC above than 100/microliter (odds ratio : 1.39, 95%CI : 0.41-4.69). There were 17 episodes of bacteremia (28.8% of 59 febrile episodes) in patients with APC less than 500/microliter and 3 episodes of bacteremia (9.7% of 31 febrile episodes) in patients with APC above than 500/microliter (P=0.03, odds ratio : 3.78, 95%CI : 1.01-14.10). CONCLUSION: There was a statistically-significant correlation between bacteremia and APC with higher risk of bacteremia in patients with APC less than 500/microliter. Trials should be conducted to test whether APC may be used to assign some children to less intensive or outpatient antibiotic therapy at the time of presentation of febrile neutropenia.