Prognostic implication of leucocyte subpopulations in diffuse large B-cell lymphoma
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Xiao Han1,*, Jing Ruan1,*, Wei Zhang1, Daobin Zhou1, Dongsheng Xu2, Qiang Pei1, Mingqi Ouyang1 and Mengxuan Zuo1
1Department of Hematology, Peking Union Medical College Hospital, Beijing, China 100730
2Department of Hematopathology, CBLPath, Sonic Healthcare, Rye Brook, NY 10573, USA
*These authors have contributed equally to this work
Wei Zhang, email: firstname.lastname@example.org
Keywords: diffuse large B-cell lymphoma, prognosis, CD16- monocyte/CD16+ monocyte ratio, mature neutrophil/cytotoxic NK&T cell ratio, CytoDiff flow cytometric system
Received: November 02, 2016 Accepted: March 08, 2017 Published: May 12, 2017
Background: Recent studies have suggested that variables related to host adaptive immunity and the tumor microenvironment may predict the outcome in patients with non-Hodgkin’s lymphoma. This study was undertaken to determine the prognostic value of peripheral blood leucocyte subpopulations in diffuse large-B-cell lymphoma patients.
Methods: We prospectively analyzed the 16 leukocyte subpopulations using Cytodiff flow cytometric technique in a cohort of 45 diffuse large-B-cell lymphoma patients at a single institution between February and December 2014. The Cox proportional hazards model was used to evaluate prognostic factors for overall survival and progression free survival.
Results: Diffuse large-B-cell lymphoma patients had decreased cytotoxic and non-cytotoxic NK&T cells as well as increased CD16+ monocytes, CD16- monocytes and mature neutrophils. The decreased CD16- monocyte/CD16+ monocyte ratio and increased mature neutrophil/cytotoxic NK&T cell ratio were related to poor progression-free and overall survival outcome in single and multivariate analysis. The co-constructed model using International Prognostic Index and mature neutrophil/cytotoxic NK&T cell ratio can also help discriminate the clinical outcome.
Conclusions: The decreased CD16-monocyte/CD16+monocyte ratio and increased mature neutrophil/cytotoxic NK&T cell ratio predict poor prognosis in diffuse large-B-cell lymphoma patients. This finding provides a strong rationale for the study of cellular immunotherapy in B-cell lymphoma.
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