Host immune homeostasis as an independent prognostic indicator has been inadequately evaluated in aggressive non-Hodgkin's lymphomas (NHL). The present study addresses the prognostic significance in aggressive NHLs of the immunologic profile evaluated by pretreatment serum levels of immunoglobulins (Ig) and lymphocyte-monocyte ratio (LMR). In this series of 90 patients with aggressive lymphoma, the median level for IgG was 1,024mg/dl (range 436-2236), and for LMR was 2.2 (range 0.2-13.8). CR rate was higher with IgG levels ≥1,024mg/dL (91% vs 77% p=0.059). LMR ≤ 2.2 was associated with lower 1-year PFS (73% vs. 92%, p 0.016). Patients with good/very good R-IPI showed a reduced PFS if IgG or LMR was low, while patients with poor R-IPI did better if LMR or IgG levels were high. We combined both parameters with the R-IPI and produced a four-risk prognostic score showing one-year PFS of 95% (95% CI 68%-99%), 100% (95% CI 100%-100%), 73% (95% CI 52%-86%), and 59% (95% CI 31%-79%), in patients with zero, one, two and three risk factors, respectively. The results indicate for the first time the value of baseline serum Ig levels in the prognostic assessment of aggressive lymphoma.

中文翻译：

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基线免疫学特征对侵袭性B细胞非霍奇金淋巴瘤的预后影响。

宿主免疫稳态作为独立的预后指标在侵袭性非霍奇金淋巴瘤（NHL）中没有得到充分评估。本研究通过免疫球蛋白（Ig）和淋巴细胞-单核细胞比率（LMR）的预处理血清水平评估了免疫学特征对侵袭性NHL的预后意义。在这一系列90例侵袭性淋巴瘤患者中，IgG的中位水平为1,024mg / dl（范围436-2236），而LMR的中位水平为2.2（范围0.2-13.8）。IgG浓度≥1,024mg/ dL时，CR率更高（91％vs 77％，p = 0.059）。LMR≤2.2与较低的1年PFS相关（73％对92％，p = 0.016）。如果IgG或LMR较低，则具有良好/非常好的R-IPI的患者的PFS会降低，而如果LMR / IgG含量较高，则R-IPI较差的患者的PFS会更好。我们将这两个参数与R-IPI结合使用，得出了四风险预后评分，显示一年PFS分别为95％（95％CI 68％-99％），100％（95％CI 100％-100％），73分别具有0、1、2和3个危险因素的患者分别占95％CI（95％CI 52％-86％）和59％（95％CI 31％-79％）。结果首次表明基线血清Ig水平在侵袭性淋巴瘤预后评估中的价值。