The use of a blood test to predict future outcomes for patients with relapsed diffuse large B-cell lymphoma

This study looked at how effective a blood test was at predicting future outcomes in patients with relapsed or difficult to treat diffuse large B-cell lymphoma. The study concluded that the lymphocyte-to-monocyte ratio blood test is very effective at predicting future outcomes for patients with relapsed or difficult to treat diffuse large B-cell lymphoma.

Diffuse large B-cell lymphoma (DLBCL) is a common type of non-Hodgkin lymphoma. Rituximab (Rituxan) has improved survival rates for patients with DLBCL. The standard of care is R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone) chemotherapy. About 30% of patients will relapse after R-CHOP. Patients with relapsed or difficult to treat (refractory) DLBCL continue to have poor outcomes.

Second line therapy is given based on patient risk for future relapse. The lymphocyte-to-monocyte ratio (LMR) blood test has been shown to predict future treatment outcomes for patients with Hodgkin lymphoma. More research is needed to determine if LMR is effective at predicting outcomes for patients with relapsed or refractory DLBCL. 

The medical records of 74 patients were reviewed. 34 patients had relapsed DLBCL. 40 patients had refractory DLBCL. All patients were already treated with R-CHOP or a similar regimen. The average length of follow up was 31.3 months.

A low LMR was defined as less than or equal to 2.6. A high LMR was defined as greater than 2.6.

The 2-year overall survival (OS; time from treatment to death from any cause) for all patients was 43.0%. The 2-year OS was significantly higher for patients with a high LMR (79.4%) compared to patients with a low LMR (22.4%).

The authors concluded that LMR can help to identify patients with relapsed or refractory DLBCL who are at higher risk for poor outcomes in the future, and that having a low LMR is associated with poor outcomes for patients.