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Immunochemotherapeutic increase of peripheral absolute monocyte count predicts interstitial pneumonia in lymphoma

Mingxiao Lang1, Jingwei Yu1, Xianhuo Wang1

  • 1National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Sino-US Center for Lymphoma and Leukemia, Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.

Hematological Oncology
|August 26, 2018
PubMed

Insights

An increase in absolute monocyte count (AMC) during immunochemotherapy may predict interstitial pneumonia (IP) in lymphoma patients. Monitoring AMC changes can help identify patients at risk for IP and guide treatment adjustments.

Area of Science:

  • Oncology
  • Pulmonology
  • Hematology

Background:

  • Interstitial pneumonia (IP) is a serious adverse event in lymphoma patients receiving immunochemotherapy.
  • Risk factors and predictive markers for IP remain poorly understood.
  • Absolute monocyte count (AMC) changes during treatment may be linked to IP development.

Purpose of the Study:

  • To investigate the correlation between changes in absolute monocyte count (AMC) and the occurrence and progression of interstitial pneumonia (IP) in lymphoma patients undergoing immunochemotherapy.
  • To identify potential predictive markers for IP in this patient population.

Main Methods:

  • Retrospective study of 500 lymphoma patients treated with immunochemotherapy between 2014 and 2016.
  • Diagnosis of IP based on computed tomography (CT) scans, respiratory symptoms, and pulmonary function tests.
  • Analysis of peripheral AMC levels at different time points during chemotherapy, including multivariate analysis to identify independent risk factors.

Main Results:

  • 40 out of 500 patients (8%) developed IP, with a median of 4 chemotherapy cycles prior to diagnosis.
  • An increase in peripheral AMC over 0.565 × 10^9 /L after 2 cycles of immunochemotherapy was associated with a higher risk of developing IP.
  • Lymphoma lung involvement and elevated AMC after 2 cycles were identified as independent risk factors for IP.
  • Sustained AMC elevation (>0.575 × 10^9 /L) at IP onset correlated with severe pulmonary symptoms, while AMC decrease suggested better tolerance to treatment.

Conclusions:

  • Early increase in absolute monocyte count (AMC) during immunochemotherapy in lymphoma patients, particularly those with lung involvement, is a significant potential predictor of interstitial pneumonia (IP).
  • Dynamic monitoring of AMC may serve as a valuable biomarker for predicting IP severity and guiding treatment adjustments for both the malignancy and pulmonary complications.

Keywords:
absolute monocyte countinterstitial pneumonialymphomapredictive markerrisk factors

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