Journal Article

Prognostic value of lymphocyte-monocyte ratio at diagnosis in Hodgkin lymphoma: a meta-analysis

Ng, Ting Ying, Lee, Shing Fung, Spika, Devon

2019

Overview

Background Prognoses of most adult Hodgkin lymphoma (HL) patients are excellent; most of them can achieve permanent remission that can be considered cured. However, many are under-treated or over-treated by standard modern therapies. An accurate determination of prognosis may allow clinicians to design personalised treatment according to individual risk of disease progression and survival. Lymphocyte monocyte ratio (LMR) at diagnosis has been investigated as a prognostic biomarker in patients with HL. Our objective with this meta-analysis was to explore the prognostic value of the LMR at diagnosis in adult HL, by investigating the association between LMR and survival outcomes. Methods PUBMED and EMBASE were searched for relevant articles. Survival outcomes that we investigated included overall survival (OS), progression-free survival (PFS), event-free survival (EFS), lymphoma-specific survival (LSS), and time to progression (TTP). No restriction to the language, date, study country, or sample size was applied. Final search of databases was performed on 2 April 2018. We performed random-effects meta-analysis to aggregate and summarise the results from included studies, where four or more studies on a particular outcome were available. Results A total of eight studies (all retrospective cohort studies) involving 3319 HL patients were selected for analysis. All studies except one reported the effect of LMR on OS; five reported on PFS, three reported on TTP and LSS, respectively, and one reported on EFS. The pooled estimates showed low LMR was associated with poor OS (hazard ratio [HR] 2.67, 95% CI 1.67, 4.26) and PFS (HR 2.19, 95% CI 1.46, 3.29). Subgroup analyses of OS stratified by LMR cut-off values and sample sizes both indicated that low baseline LMR was associated with poorer prognosis. Conclusions Low LMR at diagnosis was associated with poor OS and PFS in HL. LMR is easy and cheap to determine and has a potential role in daily clinical management. More studies are needed to validate this biomarker and explore its interaction with known prognostic factors.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Age / B cells / Biological markers / Biomarkers / Biomedical and Life Sciences / Biomedicine / Blood tests / Cancer and Oncology / Cancer och onkologi / Cancer Research / Cancer therapies / Chemotherapy / Clinical Medicine / Diagnosis / Disease / Gene expression / Health Promotion and Disease Prevention / Hodgkin Disease - blood / Hodgkin Disease - diagnosis / Hodgkin Disease - mortality / Hodgkin lymphoma / Hodgkin's lymphoma / Humans / Klinisk medicin / Leukocyte Count / Lymphocyte / Lymphocyte Count / Lymphocytes / Lymphoma / Lymphomas / Medical and Health Sciences / Medical prognosis / Medical research / Medicin och hälsovetenskap / Medicine/Public Health / Meta-analysis / Monocyte / Monocytes / Oncology / Patients / Prognosis / Publication Bias / Radiation therapy / Remission / Research Article / Risk assessment / Studies / Surgical Oncology / Survival Analysis / Systematic review / Tumors / Young adults