Prognostic implication of leucocyte subpopulations in diffuse large B-cell lymphoma

// Xiao Han 1, * , Jing Ruan 1, * , Wei Zhang 1 , Daobin Zhou 1 , Dongsheng Xu 2 , Qiang Pei 1 , Mingqi Ouyang 1 and Mengxuan Zuo 1 1 Department of Hematology, Peking Union Medical College Hospital, Beijing, China 100730 2 Department of Hematopathology, CBLPath, Sonic Healthcare, Rye Brook, NY 10573, USA * These authors have contributed equally to this work Correspondence to: Wei Zhang, email: vv1223@vip.sina.com Keywords: diffuse large B-cell lymphoma, prognosis, CD16- monocyte/CD16+ monocyte ratio, mature neutrophil/cytotoxic NK&T cell ratio, CytoDiff flow cytometric system Received: November 02, 2016     Accepted: March 08, 2017     Published: May 12, 2017 ABSTRACT Background: Recent studies have suggested that variables related to host adaptive immunity and the tumor microenvironment may predict the outcome in patients with non-Hodgkin’s lymphoma. This study was undertaken to determine the prognostic value of peripheral blood leucocyte subpopulations in diffuse large-B-cell lymphoma patients. Methods: We prospectively analyzed the 16 leukocyte subpopulations using Cytodiff flow cytometric technique in a cohort of 45 diffuse large-B-cell lymphoma patients at a single institution between February and December 2014. The Cox proportional hazards model was used to evaluate prognostic factors for overall survival and progression free survival. Results: Diffuse large-B-cell lymphoma patients had decreased cytotoxic and non-cytotoxic NK&T cells as well as increased CD16+ monocytes, CD16- monocytes and mature neutrophils. The decreased CD16- monocyte/CD16+ monocyte ratio and increased mature neutrophil/cytotoxic NK&T cell ratio were related to poor progression-free and overall survival outcome in single and multivariate analysis. The co-constructed model using International Prognostic Index and mature neutrophil/cytotoxic NK&T cell ratio can also help discriminate the clinical outcome. Conclusions: The decreased CD16-monocyte/CD16+monocyte ratio and increased mature neutrophil/cytotoxic NK&T cell ratio predict poor prognosis in diffuse large-B-cell lymphoma patients. This finding provides a strong rationale for the study of cellular immunotherapy in B-cell lymphoma.