Koh et al evaluated patients with classic Hodgkin's disease using the ratio of the absolute neutrophil count to the absolute lymphocyte count. The authors are from the University of Ulsan College of Medicine and Seoul National University in Seoul, South Korea.
Patient selection: classic Hodgkin' disease
Parameters at presentation:
(1) absolute neutrophil count (ANC)
(2) absolute lymphocyte count (ALC)
(3) absolute monocyte count (AMC)
(4) limited vs advanced stage disease
ratio of ANC to ALC =
= (ANC) / (ALC)
ratio of ALC to AMC =
= (ALC) / (AMC)
ANC/ALC Ratio
ALC/AMC Ratio
20 Year Survival
< 4.3
>= 2.9
95%
< 4.3
< 2.9
88%
>= 4.3
>= 2.9
88%
>= 4.3
< 2.9
67%
ANC/ALC Ratio
Stage
20 Year Survival
< 4.3
limited
96%
< 4.3
advanced
86%
>= 4.3
limited
88%
>= 4.3
advanced
65%
The ratios also help to distinguish prognostic subgroups in patients classified by the International Prognostic Score.
On multivariate analysis another independent factor for overall survival was the presence or absence of B symptoms (hazard ratio 2.3).
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