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Prognostic performance of lymphocyte-to-monocyte ratio in diffuse large B-cell lymphoma: an updated meta-analysis of eleven reports

Authors Sun H, Pan Y, He B, Nie Z, Lin K, Peng H, Cho W, Wang S

Received 23 September 2015

Accepted for publication 2 February 2016

Published 20 May 2016 Volume 2016:9 Pages 3017—3023


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Ram Prasad

Peer reviewer comments 3

Editor who approved publication: Professor Daniele Santini

Hui-Ling Sun,1,* Yu-Qin Pan,1,* Bang-Shun He,1 Zhen-Lin Nie,2 Kang Lin,1 Hong-Xin Peng,1,3 William C Cho,4 Shu-Kui Wang1

1Central Laboratory, 2Laboratory Medicine, Nanjing First Hospital, Nanjing Medical University, 3Medical College, Southeast University, Nanjing, 4Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong, People’s Republic of China

*These authors contributed equally to this work

Purpose: The findings on the prognostic value of lymphocyte-to-monocyte ratio (LMR) in diffuse large B-cell lymphoma (DLBCL) are inconsistent. This meta-analysis was conducted to more precisely evaluate the prognostic significance of LMR in DLBCL.
Methods: This analysis combined eleven studies with 4,578 patients aiming to assess the association of LMR with overall survival (OS) and progression-free survival (PFS) in DLBCL. Data from studies directly reporting a hazard ratio (HR) with 95% corresponding confidence interval (CI) in multivariate analysis were pooled to estimate the effect.
Results: Our results suggested that patients with decreased LMR had shorter OS (HR =1.79, 95% CI =1.54–2.08, P<0.001) and PFS (HR =2.21, 95% CI =1.80–2.72, P<0.001) in DLBCL. Stratified analyses indicated that each confounder showed consistent prognostic value in DLBCL. There was no significant heterogeneity for PFS (PH=0.192) and OS (PH=0.212) among the enrolled studies.
Conclusion: This meta-analysis indicated that decreased LMR might be a marker in the prediction of poor prognosis for patients with DLBCL.

Keywords: diffuse large B-cell lymphoma, lymphocyte-to-monocyte ratio, meta-analysis, prognosis

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