Correlation of peripheral blood lymphocyte-to-monocyte ratio after induction chemotherapy with treatment efficacy and prognosis in acute myeloid leukemia / 白血病·淋巴瘤

ABSTRACT

Objective:To explore the value of peripheral blood lymphocyte-to-monocyte ratio (LMR) after induction chemotherapy in patients with acute myeloid leukemia (AML) for the judgment of curative effect and prognosis.Methods:The clinical data of 63 newly-treated AML patients (except for acute promyelocytic leukemia) in Heze Municipal Hospital of Shandong Province from January 2015 to January 2020 were retrospectively analyzed. No blasts were seen on the blood films of all patients at one week after induction chemotherapy. The receiver operating characteristic (ROC) curve was used to determine the best cut-off value of LMR at one week after the completion of all induction chemotherapy for predicting complete remission (CR) of patients, and based on this value, the patients were divided into the low LMR group (LMR <the best cut-off value) and the high LMR group (LMR ≥ the best cut-off value). The differences in clinical characteristics, laboratory test indicators, treatment efficacy, recurrence and survival between the two groups of patients were compared.Results:Sixty-three patients were enrolled in the study. The median LMR of 63 patients was 3.64 (0.13-88.01) at one week after the completion of all induction chemotherapy. Fifty-one patients (81.0%) achieved CR after one course of induction chemotherapy, 54 patients (85.7%) achieved CR after two courses, and there were finally 56 patients (88.9%) with CR. The ROC curve determined that the best cut-off value of LMR was 1.515, and there were 20 cases and 43 cases in the low LMR group and the high LMR group, respectively. There were no significant differences in age, gender, hemoglobin, bone marrow blast cell ratio, white blood cell count, platelet count, and lactate dehydrogenase levels between the two groups (all P > 0.05). The CR rates after 1 course of treatment in the low LMR group and the high LMR group were 65.0% (13/20) and 88.4% (38/43), respectively, and the difference was statistically significant ( χ2=4.836, P=0.028). In the low LMR group, 3 of the 13 patients who achieved CR within 1 course of treatment relapsed; in the high LMR group, 2 of the 38 patients who achieved CR within 1 course of treatment relapsed. The 3-year RFS rates of the low LMR group and the high LMR group were 64% and 80%, respectively, and the difference was not statistically significant ( χ2=2.897, P=0.089); the 3-year OS rates were 84% and 80%, respectively, and the difference was not statistically significant ( χ2=0.136, P=0.712). Conclusion:For newly-treated AML patients with no nucleated cells in blood smear microscopy at one week after the completion of induction chemotherapy, LMR may be used to evaluate the treatment efficacy and recurrence.