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Original Article
Prognostic Significance of Absolute Lymphocyte Count/Absolute Monocyte Count Ratio at Diagnosis in Patients with Multiple Myeloma
Su-Jin Shin, Jin Roh, Misung Kim, Min Jung Jung, Young Wha Koh, Chan-Sik Park, Dok Hyun Yoon, Cheolwon Suh, Chan-Jeong Park, Hyun Sook Chi, Jooryung Huh
Korean J Pathol. 2013;47(6):526-533.   Published online December 24, 2013
DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.6.526
  • 11,140 View
  • 86 Download
  • 24 Crossref
AbstractAbstract PDF
Background

Absolute lymphocyte count (ALC) in peripheral blood has recently been reported to be an independent prognostic factor in multiple myeloma (MM). Previous studies indicated that the absolute monocyte count (AMC) in peripheral blood reflects the state of the tumor microenvironment in lymphomas. Neither the utility of the AMC nor its relationship with ALC has been studied in MM.

Methods

The prognostic value of ALC, AMC, and the ALC/AMC ratio at the time of diagnosis was retrospectively examined in 189 patients with MM.

Results

On univariate analysis, low ALC (<1,400 cells/µL), high AMC (≥490 cells/µL), and low ALC/AMC ratio (<2.9) were correlated with worse overall survival (OS) (p=.002, p=.038, and p=.001, respectively). On multivariate analysis, the ALC/AMC ratio was an independent prognostic factor (p=.047), whereas ALC and AMC were no longer statistical significant. Low ALC, high AMC, and low ALC/AMC ratio were associated with poor prognostic factors such as high International Staging System stage, plasmablastic morphology, hypoalbuminemia, and high β2-microglobulin.

Conclusions

Univariate analysis demonstrated that changes in ALC, AMC, and the ALC/AMC ratio are associated with patient survival in MM. Multivariate analysis showed that, of these factors, the ALC/AMC ratio was an independent prognostic factor for OS.

Citations

Citations to this article as recorded by  
  • Variation of peripheral blood-based biomarkers for response of anti-PD-1 immunotherapy in non-small-cell lung cancer
    Xiaoming Wang, Dayu Chen, Yuyan Ma, Dongping Mo, Feng Yan
    Clinical and Translational Oncology.2024; 26(8): 1934.     CrossRef
  • Descriptive analysis and prognostic factors in cats with myeloma‐related disorders: A multicenter retrospective study of 50 cases
    Lorris Lecot, Isabelle Desmas‐Bazelle, Sarah Benjamin, Pauline De Fornel, Frédérique Ponce, Matthew Kornya, Loïc Desquilbet, Claire Beaudu‐Lange, Catherine Ibisch, David Sayag, Ghita Benchekroun, Jérémy Béguin
    Journal of Veterinary Internal Medicine.2024; 38(3): 1693.     CrossRef
  • Definers and drivers of functional high-risk multiple myeloma: insights from genomic, transcriptomic, and immune profiling
    Rahul Banerjee, Kara I. Cicero, Sarah S. Lee, Andrew J. Cowan
    Frontiers in Oncology.2023;[Epub]     CrossRef
  • Normal Absolute Monocyte Count in Combination with Normal/High Absolute Lymphocyte Count at the Time of Relapse is Associated with Improved Survival in Patients with Early Relapsed Acute Myeloid Leukemia
    Yu Zhang, Kanchun Dai, Qianying Zhang, Yisha Huang, Yiyun Feng, Deeksha Bhardwaj, Kang Yu, Jianhua Feng
    Cancer Investigation.2021; 39(6-7): 550.     CrossRef
  • Real World Experience of Daratumumab: Evaluating Lymphopenia and Adverse Events in Multiple Myeloma Patients
    Francesca Cottini, Ying Huang, Nita Williams, Naresh Bumma, Abdullah M. Khan, Maria Chaudhry, Srinivas Devarakonda, Yvonne A. Efebera, Don M. Benson, Ashley E. Rosko
    Frontiers in Oncology.2021;[Epub]     CrossRef
  • Are the Derived Indexes of Peripheral Whole Blood Cell Counts (NLR, PLR, LMR/MLR) Clinically Significant Prognostic Biomarkers in Multiple Myeloma? A Systematic Review And Meta-Analysis
    Xinwen Zhang, Jialin Duan, Zhenyu Wen, Hao Xiong, Xiaomin Chen, Yang Liu, Kunyu Liao, Chunlan Huang
    Frontiers in Oncology.2021;[Epub]     CrossRef
  • Combined immune score of lymphocyte to monocyte ratio and immunoglobulin levels predicts treatment-free survival of multiple myeloma patients after autologous stem cell transplant
    Karen Sweiss, Jonathan Lee, Nadim Mahmud, Gregory S. Calip, Youngmin Park, Dolores Mahmud, Damiano Rondelli, Pritesh R. Patel
    Bone Marrow Transplantation.2020; 55(1): 199.     CrossRef
  • Low absolute CD4+ T cell counts in peripheral blood predict poor prognosis in patients with newly diagnosed multiple myeloma
    Yan Gu, Yuanyuan Jin, Jie Ding, Wu Yujie, Qinglin Shi, Xiaoyan Qu, Sishu Zhao, Jianyong Li, Chen Lijuan
    Leukemia & Lymphoma.2020; 61(8): 1869.     CrossRef
  • Normal Absolute Monocyte Count at the Time of Relapse is Associated with Improved Survival After First Salvage Therapy in Adult Patients with Early Relapsed B-Lineage Acute Lymphoblastic Leukemia


    Yi-fen Shi, Na Wang, Zi-yang Huang, Rong-rong Chen, Yi-sha Huang, Yi-yi Zhu, Chong-yun Xing, Bin Liang, Kang Yu, Jian-hua Feng
    Cancer Management and Research.2020; Volume 12: 7097.     CrossRef
  • Peripheral blood biomarkers of early immune reconstitution in newly diagnosed multiple myeloma
    Moritz Binder, S. Vincent Rajkumar, Martha Q. Lacy, Morie A. Gertz, Francis K. Buadi, Angela Dispenzieri, Yi L. Hwa, Amie Fonder, Miriam Hobbs, Suzanne R. Hayman, Steven R. Zeldenrust, John A. Lust, Stephen J. Russell, Nelson Leung, Prashant Kapoor, Ronal
    American Journal of Hematology.2019; 94(3): 306.     CrossRef
  • Effect of absolute monocyte count post-transplant on the outcome of patients with acute myeloid leukemia undergoing myeloablative allogeneic hematopoietic stem cell transplant with busulfan and cyclophosphamide conditioning
    Liyuan Tang, Na Wang, Chongyun Xing, Qiang Zhuang, Bin Liang, Lan Sun, Yi Chen, Yan Qian, Zhijian Shen, Songfu Jiang, Kang Yu, Jianhua Feng
    Leukemia Research.2018; 69: 60.     CrossRef
  • A lower ALC/AMC ratio is associated with poor prognosis of peripheral T-cell lymphoma-not otherwise specified
    Qian Li, Shuang Gao, Jing Ma, Su Liu, Yuanfang Yue, Lin Chen, Han Li, Xue Wang, Dongying Li, Zeng Cao, Zhigang Zhao, Xiaofang Wang, Yong Yu, Yizhuo Zhang, Yafei Wang
    Leukemia Research.2018; 73: 5.     CrossRef
  • Peripheral Blood Lymphocyte-to-Monocyte Ratio as a Useful Prognostic Factor in Newly Diagnosed Multiple Myeloma
    Ying Tian, Yue Zhang, Wan-Qiu Zhu, Xiao-Lei Chen, He-Bing Zhou, Wen-Ming Chen
    BioMed Research International.2018; 2018: 1.     CrossRef
  • Significance of the absolute lymphocyte/monocyte ratio as a prognostic immune biomarker in newly diagnosed multiple myeloma
    T Dosani, F Covut, R Beck, J J Driscoll, M de Lima, E Malek
    Blood Cancer Journal.2017; 7(6): e579.     CrossRef
  • Lymphocyte-to-monocyte ratio can predict mortality in pancreatic adenocarcinoma
    Gurshawn Singh, Ammar Nassri, David Kim, Hong Zhu, Zeeshan Ramzan
    World Journal of Gastrointestinal Pharmacology and Therapeutics.2017; 8(1): 60.     CrossRef
  • Bone marrow microenvironmental CD4 + and CD8 + lymphocyte infiltration patterns define overall- and progression free survival in standard risk multiple myeloma – an analysis from the Austrian Myeloma Registry
    Wolfgang Willenbacher, Ella Willenbacher, Claudia Zelle-Rieser, Rainer Biedermann, Roman Weger, Karin Jöhrer, Andrea Brunner
    Leukemia & Lymphoma.2016; 57(6): 1478.     CrossRef
  • Absolute lymphocyte count as a prognostic marker in newly diagnosed multiple myeloma patients
    C. Suriu, L. Akria, D. Azoulay, E. Shaoul, M. Barhoum, A. Braester
    International Journal of Laboratory Hematology.2016;[Epub]     CrossRef
  • The Peripheral Blood Mononuclear Cell Count Is Associated With Bone Health in Elderly Men
    Xianfeng Lin, Hejun Yu, Chenchen Zhao, Yu Qian, Dun Hong, Kangmao Huang, Jian Mo, An Qin, Xiangqian Fang, Shunwu Fan
    Medicine.2016; 95(15): e3357.     CrossRef
  • Prognostic role of lymphocyte to monocyte ratio for patients with cancer: evidence from a systematic review and meta-analysis
    Liangyou Gu, Hongzhao Li, Luyao Chen, Xin Ma, Xintao Li, Yu Gao, Yu Zhang, Yongpeng Xie, Xu Zhang
    Oncotarget.2016; 7(22): 31926.     CrossRef
  • Do lymphocytes count in myeloma? Are we absolutely sure?
    Tamar Tadmor
    Leukemia & Lymphoma.2015; 56(5): 1193.     CrossRef
  • Absolute lymphocyte count is unrelated to overall survival in newly diagnosed elderly patients with multiple myeloma treated with immunomodulatory drugs
    Mariasanta Napolitano, Giorgia Saccullo, Roberto Bono, Antonio Branca, Clotilde Cangialosi, Salvatrice Mancuso, Simona Raso, Gerlando Quintini, Maria Grazia Lipari, Francesco Fabbiano, Giorgina Specchia, Alberto Dolce, Francesco Di Raimondo, Sergio Siragu
    Leukemia & Lymphoma.2015; 56(5): 1507.     CrossRef
  • Distinct Transcriptional and Anti-Mycobacterial Profiles of Peripheral Blood Monocytes Dependent on the Ratio of Monocytes: Lymphocytes
    Vivek Naranbhai, Helen A. Fletcher, Rachel Tanner, Matthew K. O'Shea, Helen McShane, Benjamin P. Fairfax, Julian C. Knight, Adrian V.S. Hill
    EBioMedicine.2015; 2(11): 1619.     CrossRef
  • Prognostic value of absolute monocyte count in chronic lymphocytic leukaemia
    László Szerafin, János Jakó, Ferenc Riskó
    Orvosi Hetilap.2015; 156(15): 592.     CrossRef
  • The lymphocyte to monocyte ratio in peripheral blood represents a novel prognostic marker in patients with pancreatic cancer
    Michael Stotz, Joanna Szkandera, Tatjana Stojakovic, Julia Seidel, Hellmut Samonigg, Peter Kornprat, Renate Schaberl-Moser, Fridericke Seggewies, Gerald Hoefler, Armin Gerger, Martin Pichler
    Clinical Chemistry and Laboratory Medicine (CCLM).2015;[Epub]     CrossRef
Review
Cytological Diagnosis of Lung Cancer: The Diagnostic Accuracy and Pitfalls.
Hyun Sook Chi, Je Geun Chi
Korean J Cytopathol. 2008;19(1):1-8.
DOI: https://doi.org/10.3338/kjc.2008.19.1.1
  • 2,319 View
  • 45 Download
  • 1 Crossref
AbstractAbstract PDF
The role of respiratory cytology is to detect and classify pulmonary disease, with an emphasis of neoplastic disease, so that proper therapy can be instituted. As in many branches of cytology, the recognition of malignancy in the cells obtained from the respiratory tract is more straightforward than identifying the type of tumor cell. It is important to accurately determine the true cytopathological cell type in cases of primary lung cancer and to know the accuracy of the diagnosis achieved by the cytological procedures. The well differentiated tumors have characteristic cytoplasmic and nuclear abnormalities that enable physicians to firmly categorize these lesions, as in squamous cell or adenocarcinoma, but some moderately and most poorly differentiated tumors show few distinctive features. This article reviews the malignant and reactive pulmonary cytologic findings and we also report on some of their pitfalls and the cytologic criteria.

Citations

Citations to this article as recorded by  
  • Fine Needle Aspiration Cytology of Metastatic Adenocarcinoma of the Gingiva from the Lung: A Case Report
    Tack Kune You, So Ri Kim, Ho Sung Park, Kyu Yun Jang, Woo Sung Moon, Myoung Ja Chung, Dong Geun Lee, Myoung Jae Kang
    Korean Journal of Pathology.2012; 46(1): 101.     CrossRef
Case Report
Immunoblastic Sarcoma Arising in Angiommunoblastic Lymphadenopathy: A case report.
Youn Wha Kim, Hyun Sook Chi, Jung Kook Lee, Hui Joong Yoon
Korean J Pathol. 1986;20(3):388-394.
  • 1,417 View
  • 10 Download
AbstractAbstract
Angioimmunoblastic lymphadenopathy (AILD) is a systemic disease clinically characterized by fever, generalized lymphadenopathy, hepatosplenomegaly, polyclonal gamma-globulinemia and Cooms' positive hemolytic anemia. The lymph node in AILD reveals a polymorphic feature consisting of a proliferation of small vessels, immunoblasts and plasma cells and acidophilic interstitial material. Progression into immunoblastic sarcoma is reported as high 35% of the patient with AILD. Nathwani et al have observed not only malignant transformation of AILD in sequential tissue examination, but also the coexistence of AILD and immunoblastic lymphoma in the same lymph node or at different sites in the same patient. Multiple clusters or islands of compactly arranged large lymphoid cells constitute the initial histologic evidence of immunoblastic sarcoma. Immunoblastic sarcoma is a large cell lymphoma conceptually related to transformed T-and B-lymphocytes of the extrafollicular compartment of the immune system, which proignosis is poor. We have recently experienced a case of immuno blastic sarcoma arising in angioimmunoblastic lymphadenopathy in a 24-year-old woman. She had history of multiple enlarged lymph nodes in the inguinal, axilla and supraclavicular areas. Previous lymph node biopsies revealed reactive change. Six month later, right axillary lymph node biopsy reveled AILD with focal clusters of immunoblasts. Subsequent lymph node biopsy at the same site revealed diffuse immunoblasic sarcoma, B-cell type. A case presentation with histologic findings and a brief review of literature were done.
Original Article
Studies on Morphology and Fibrinolytic Activity of Ganglionic Eminence.
Hyun Sook Chi, Je Geun Chi
Korean J Cytopathol. 1985;19(1):1-12.
  • 1,439 View
  • 23 Download
AbstractAbstract PDF
Ganglionic eminence initially appears as a slight swelling in the floor of the cerebral vesicle during the 5th fetal week and attains maximum prominence late in the 4th fetal month; it then declines in relative size, and nearly disappears after birth. The ganglionic eminence constitutes a collection of the proliferating cells throughout most of span of gestation and supply neuroblasts and spongioblasts to basal ganglia and pulvinar region of thalamus and cerebral cortex. Nowadays intraventricular hemorrhage predominantly occurs in preterm infants of less than 32 weeks gestational age, and the intraventricular hemorrhage arises most frequently from rupture of a ganglionic eminence hemorrhage is equally frequent in both hemispheres and is associated with an extensive destruction of the capillary bed without arterial or venous rupture. Although fibrin thrombi are seen within veins in relation to ruptures at the capillary vein junction, the other study reveals little or no fibrin is to be seen within the ganglionic eminence hemorrhage presumably due to the high fibrinolytic activity within this region of the immature brain. Accordingly this study was planned to evaluate the ganglionic eminence of fetal brain in two aspects, i.e., morphological development of ganglionic eminence during gestation and functional maturation by measuring fibrinolytic activity of various portions of developing brains. To evaluate the development of ganglionic eminence a total of 97 brains of Korean fetuses of gestational ages ranging from 16 to 37 weeks, was studied; 62 for morphological study and 35 for functional study. The fetuses were products of therapeutic abortions, and were proved to be normal after complete examination of fetuses and placentas. The brains were removed as soon as possible after delivery, and were fixed in 10% formalin for 1 to 2 weeks before being examined. Representative blocks containing white matte around lateral ventricle, ganglionic eminence, caudate nucleus and thalamus on the serial coronal sections. Through routine histological procedure, slides were made and stained with hematoxylin and eosin for microscopical examination of the ganglionic eminence and striatum. The fibrionlytic activity of the tissue was measured by fibrin plate method of Astrup and Albrechtsen and the amount of lysis expressed as area/mg of wet tissues. As controls comparable aliquots of 2M potassium thiocyanate or saline alone had no fibrinolytic activity. To detect the in vivo fibrinolysis, fibrin and/or fibrinogen degradation product, staphylococcal clumping tests for the tissue extracts were performed. Following results were obtained. 1) The ganglionic eminence was well formed and located at the lateral side of terminal vein and over the caudate nucleus and protruded into the lateral ventricle. 2) The thickness of the ganglionic eminence is reached to maximum width by 20th week of gestation and is shown a progressive reduction till 30th week, and revealed sharp reduction after 31th week of gestation and became no longer recognizable after 37th week of gestation. 3) The ependymal layer was most thickened at 16~19th week of gestation, showing 6~8 layers with numerous mitoses and declined to 2~3 layers at 28~31th week of gestation and no more mitosis was found. 4) The distribution of capillary beds were most pronounced at 16~19th week of gestation and the permeation of the capillaries to the ependymal zone and decreased in number after 20th week of gestation. The medium sized, well developed veins were demonstrable at the junction of ganglionic eminence and caudate nucleus from 24th week of gestation. 5) The fibrinolytic activity of the choroid plexus and leptomeninges were significantly increased than the other areas(p<0.005) and there was no evidence of gestational changes. 6) The fibrinolytic activity of the ganglionic eminence was no more pronounced than those of cerebral cortex, periventricular white matter, cerebellum and spinal cord.

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