A new prognostic indicator involving monocytes has been identified for patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL), according to research presented at the 22nd Congress of the European Hematology Association (June 22-25, 2017; Madrid, Spain).
Increasing interest is being accrued in the role of myeloid-lineage cells, particularly monocytes and their precursors, in the prognosis of various lymphomas. Recent research has shown that circulating monocyte count at the time of diagnosis has prognostic implications. CD11b-positive monocytes expressing CX3CR1 help suppress anti-tumor immunity. However, data is limited regarding the prognostic significance of such monocytes in patients with newly diagnosed DLBCL.
Jae Yong Kwak, MD, PhD, internal medicine, Chonbuk National University Hospital (South Korea), and colleagues conducted a study to assess the prognostic implications of peripheral blood and bone marrow CD11b-positive CX3CR1-expressing monocytes on progression-free survival (PFS) and overall survival (OS) in newly diagnosed DLBCL patients treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone. A total of 89 patients (median age, 65 years) were enrolled from two Korean institutions from 2011 to 2015.
Researchers used the National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI) to classify 37 (41.6%) of patients as high-intermediate or high risk. CD11b-positive CX3CR1-expressing monocytes were detected in all peripheral blood and bone marrow samples, with a median percentage of 3.31% in peripheral blood and 3.09% in bone marrow. Patients were categorized into high and low groups based on their percentage of CD11b-positive CX3CR1-expressing monocytes relative to the sample median.
After a median follow-up of 27.7 months, patients in the low peripheral blood group had a significantly higher 3-year PFS (77.1% vs 58.7%; P = .006) and OS (86.6% vs 58.4%; P .004) than those in the high peripheral blood group. No significant differences were observed between the high and low bone marrow groups.
Researchers concluded that, “Our study represents peripheral blood CD11b-positive CX3CR1-expressing monocytes can be used in differentiating patients with high risk for early death and are associated with risk stratification by the NCCN-IPI.”
These findings indicate the potential for therapeutic targeting in newly diagnosed DLBCL, researchers assert.—Zachary Bessette
