Prognostic Value of Peripheral Blood Lymphocyte/monocyte Ratio in Lymphoma

Objective: Lymphocyte monocyte ratio (LMR) has been considered as a prognostic factor in patients with lymphoma, which focused on diffuse large B-cell lymphoma (DLBCL) and Hodgkin lymphoma (HL). Recently, many relevant clinical studies have been published with inconsistent results. To gain a more comprehensive view of the prognostic value of LMR, we conducted a meta-analysis on the significance of peripheral LMR in all subtypes of lymphoma. Methods: PubMed, PMC, Web of Science, Embase, and Cochrane Library were searched for relevant articles to conduct a meta-analysis. Hazard ratio (HR) and its 95% confidence interval (CI) of OS and PFS were extracted and pooled on stata12.1. Results: In the meta-analysis, forty studies were eligible and a total of 10446 patients were included. Low LMR was associated with an inferior OS (HR=2.45, 95%CI 1.95-3.08) and PFS (HR=2.36, 95%CI 1.94-2.88). In the analysis of lymphoma subtypes, similar results were seen in HL, NHL, and its subtypes including DLBCL, NK/T cell lymphoma, and follicular lymphoma. In addition, low LMR was related with higher LDH (OR=2.26, 95%CI 1.66-3.09), advanced tumor staging (OR=0.41, 95%CI 0.36-0.46), IPI score (OR=0.40, 95%CI 0.33-0.48), but not with bone marrow involvement (OR=1.24, 95%CI 0.85-1.81) or pathological subtype (OR=0.69, 95%CI 0.41-1.16). Conclusion: Low LMR in peripheral blood indicates poor prognosis in patients with lymphoma. As a simple clinical indicator, peripheral blood LMR combined with existing prognostic factors can improve the accuracy of lymphoma prognosis assessment.