[Influence of Peripheral Blood Lymphocyte/Monocyte Ratio (LMR) and Its Ratio to Lactate Dehydrogenase on Prognosis of Patients with Diffuse Large B-Cell Lymphoma]

Objective: To explore the influence of lymphocyte / monocyte ratio (LMR), LMR/lactate dehydrogenase (LDH) ratio on the prognosis of patients with diffuse large B-cell lymphoma.

Methods: Clinical data of 107 newly diagnosed patients with DLBCL, including age, sex, stage, B symptoms, IPI score, ECOG score, absolute lymphocyte count, absolute value of monocytes, the ratio of lymphocyte to monocyte(LMR), LDH, LMR/LDH, and SUVmax detected by FDG-PET/CT were analyzed. The best cut-off points of LMR and LMR/LDH were determined by receiver operating characteristics (ROC) curve; the chi-square test was used to analyze the correlation of clinical factors with LMR and LMR/LDH; Spearman correlation analysis was used to determine the correlation between serum LDH level and SUVmax; the Kaplan-Meier protocol was used to compare the overall survival (OS) rate and progression-free survival (PFS) rate between LMR and LMR/LDH groups; the Cox proportional risk model was used to carry out the multivariate analysis of prognostic factors.

Results: The optimal limit value for LMR and LMR/LDH (%) determined by ROC curve was 2.535 （P＜0.05） and 0.35% （P＜0.01） respectively. Patients with an LMR<2.535 had a higher incidence of advanced Ann Arbor stage, B symptoms, higher IPI score, higher ECOG score, and elevated LDH level, while patients with LMR/LDH 0.35% had the same trend as patients with LMR <2.535. A significant positive correlation between serum LDH and SUVmax was observed by Spearman correlation analysis (P<0.001). K-M survival analysis showed that the PFS rate and OS rate in high LMR group were significantly better than that in the low LMR group (P<0.05). K-M analysis showed that the PFS rate and OS rate in high LMR/LDH group were statistical significantly better than that in low LMR/LDH group (P<0.05). Multivariate COX analysis showed that the predictive value in LMR/LDH was much better than single LMR, which may be an independent prognostic factor for patients with DLBCL.

Conclusion: At the initial diagnosis, high LMR/LDH suggests that DLBCL patient is a better prognosis.