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Open Access Highly Accessed Research article

Prognostic significance of peripheral monocyte count in patients with extranodal natural killer/T-cell lymphoma

Jia-Jia Huang12, Ya-Jun Li12, Yi Xia12, Yu Wang12, Wen-Xiao Wei12, Ying-Jie Zhu12, Tong-Yu Lin12, Hui-Qiang Huang12, Wen-Qi Jiang12 and Zhi-Ming Li12*

Author Affiliations

1 State Key Laboratory of Oncology in South China, Guangzhou, China

2 Department of Medical Oncology, Sun Yat-sen University Cancer Center, 651 Dong Feng RD East, Guangzhou 510060, China

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BMC Cancer 2013, 13:222  doi:10.1186/1471-2407-13-222

Published: 3 May 2013

Abstract

Background

Extranodal natural killer/T-cell lymphoma (ENKL) has heterogeneous clinical manifestations and prognosis. This study aims to evaluate the prognostic impact of absolute monocyte count (AMC) in ENKL, and provide some immunologically relevant information for better risk stratification in patients with ENKL.

Methods

Retrospective data from 163 patients newly diagnosed with ENKL were analyzed. The absolute monocyte count (AMC) at diagnosis was analyzed as continuous and dichotomized variables. Independent prognostic factors of survival were determined by Cox regression analysis.

Results

The AMC at diagnosis were related to overall survival (OS) and progression-free survival (PFS) in patients with ENKL. Multivariate analysis identified AMC as independent prognostic factors of survival, independent of International Prognostic Index (IPI) and Korean prognostic index (KPI). The prognostic index incorporating AMC and absolute lymphocyte count (ALC), another surrogate factor of immune status, could be used to stratify all 163 patients with ENKL into different prognostic groups. For patients who received chemotherapy followed by radiotherapy (102 cases), the three AMC/ALC index categories identified patients with significantly different survivals. When superimposed on IPI or KPI categories, the AMC/ALC index was better able to identify high-risk patients in the low-risk IPI or KPI category.

Conclusion

The baseline peripheral monocyte count is shown to be an effective prognostic indicator of survival in ENKL patients. The prognostic index related to tumor microenvironment might be helpful to identify high-risk patients with ENKL.

Keywords:
Absolute monocyte count; Extranodal natural killer/T-cell lymphoma; Prognosis; Tumor microenvironment