Relationship of Lymphocyte to Monocyte Ratio at Diagnosis with Prognosis in Patients with Diffuse Large B-cell Lymphoma: A Retrospective Study

Abstract

Aim: Although there is a complete response and increase in survival rates with rituximab in diffuse large-B-cell lymphoma (DLBCL), approximately30% of the patients face with relapse or refractory disease. International prognostic index (IPI) is the most widely used method used for identifyingrelapse and refractory disease. Recently, the lymphocyte monocyte ratio (LMR) that can be used in place of or in combination with IPI has beenproposed as an effective prognostic factor to predict clinical survival in DLBCL patients.Materials and Methods: Two hundred twenty three patients diagnosed with DLBCL at our center between 2012 and 2020 were included in thestudy. The age, gender, absolute lymphocyte count (ALC), absolute monocyte count (AMC), and follow-up time were recorded from the files of thepatients. Patients were divided into two groups as: exitus group and alive group. LMR was calculated.Results: The median age at diagnosis was 58 years. The median ALC was 1.5x103/uL, the median AMC was 0.6x103/uL, and the median LMR was 2.6.The median follow-up time was 53 months. Five-year overall survival and progression-free survival were 78% and 69%, respectively. The age wassignificantly higher in the exitus group than in the alive group (p<0.05). ALC, before and after treatment, was significantly higher in the exitusgroup than in the alive group (p<0.05). Pre-treatment AMC did not show a significant difference (p>0.05). Pre-treatment LMR level did not show asignificance difference in the exitus and alive groups (p>0.05).Conclusion: LMR alone has low prognostic determinacy. Therefore, it should be evaluated with other prognostic determinants.