41P - Prognostic significance of monocyte-lymphocyte ratio in mantle cell lymphoma

Date 20 November 2015
Event ESMO Symposium on Immuno-Oncology 2015
Session Welcome reception and general Poster viewing
Topics Lymphomas
Presenter Chandan Das
Citation Annals of Oncology (2015) 26 (suppl_8): 5-14. 10.1093/annonc/mdv514
Authors C.K. Das1, L. Kumar2, S.R. Mallick3, A. Gogia1
  • 1Medical Oncology, B.R. Ambedkar Institute Rotary Cancer Hospital (AIMS), 110029 - New Delhi/IN
  • 2Medical Oncology, All India Institute of Medical Sciences, 110029 - New Delhi/IN
  • 3Pathology, All India Institute of Medical Sciences, 110029 - New Delhi/IN



This study assessed the prognostic significance of Absolute lymphocyte count/absolute monocyte count ratio at diagnosis.as a simple biomarker combining an estimate of host immune homeostasis and tumor microenvironment.


Consecutive 50 patients with MCL who had the complete documentation were evaluated and treated with CHOP based therapy between the years 2010 and 2015 at the All India Institute of Medical Science. The absolute monocyte count/absolute lymphocyte count ratio (ALC/AMC ratio) was calculated. Statistical analysis assessed by the chi-square test or Fisher's exact test. PFS and OS were estimated using the Kaplan-Meier method and log-rank test. All statistical analyses were performed using STATA (version 13.0).


In total, 50 patients were evaluated. The median follow-up period was 12 months (range 2-84) and the median age was 57 years (range 29-80). 78% had Ann Arbor stage III or IV disease, and 42.0% had a performance status of ≥2. Serum lactate dehydrogenase levels were higher than normal in 34% patients. The high MIPI present in 94%. The median TLC and ALC and were 8.8× 109/l (range 2.4-400) and 3.1× 109/l (range 0.73-376).Treatment response data were available for 42(84%) patients (88.7%). Complete remission (CR) was achieved in 17(34%), partial response in 11(22%), stable disease in 3(6%) patients, 5(10%) patients having progressive disease. The LMR in relation to achievement of CR is insignificant (p = 0.58). Kaplan-Meier analysis showed that lower LMR at diagnosis not associated with inferior overall survival (OS) and progression-free survival (PFS) in the population (OS: P = 0.201; PFS: P = 0.501). LMR at diagnosis was also not significant in differentiating between patients with different MIPI.


In conclusion, this study fails to identify ALC/AMC ratio the prognostic significance independent of the MIPI to predict response rate and survival outcome in MCL patients and its ability to identify high-risk patients. The possibility include high percentages of High MIPI group (94%) and 46% bone marrow involvement with peripheral blood spill.

Clinical trial identification

Not applicable


All authors have declared no conflicts of interest.