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DOI: https://doi.org/10.3345/kjp.2018.06618    [Accepted]
Published online October 1, 2018.
Lymphocyte-monocyte ratio at day 14 of first cisplatin-doxorubicin chemotherapy is associated with treatment outcome of pediatric patients with localized osteosarcoma
Jun Ah Lee  , Hea Lin Oh, Dong Ho Kim, Jung Sub Lim
Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea
Correspondence:  Jun Ah Lee, Tel: +82-2-970-1248, Fax: +82-2-970-1970, 
Email: junahlee@kcch.re.kr
Received: 3 May 2018   • Revised: 28 September 2018   • Accepted: 1 October 2018
Abstract
Purpose
We aimed to determine the prognostic significance of lymphocyte counts and lymphocyte-monocyte ratio (LMR) in pediatric patients with osteosarcoma.
Methods
We retrospectively reviewed the medical records of 27 pediatric patients with localized extremity osteosarcoma treated at Korea Cancer Center Hospital between May 2002 and March 2016. Pretreatment and day 14 of first cisplatin-doxorubicin chemotherapy leukocyte counts and LMR (LMR14) were evaluated. Patients were dichotomized according to the median value of these parameters, and survival rates were compared.
Results
The median age of the 27 patients was 9.9 years (range, 3.2-14.1 years) and tumor sites were; distal femur (n=14), proximal humerus (n=7), proximal tibia (n=2), proximal fibula (n=2), and elsewhere (n=2). Patients were followed for a median of 76.4 months (range, 4.5-174.7 months), and 5-year overall (OS) and event-free survival (EFS) rates were 66.0±9.8% and 60.9±9.7%, respectively. Patients with a higher pretreatment lymphocyte count (≥ 2,320/µL) had better OS (90.9% vs. 46.2%, P=0.04) and EFS (83.9% vs. 38.5%, P=0.02). However, day 14 lymphocyte count was not associated with survival. While no survival difference was observed between patients grouped according to pretreatment LMR (median value 6.3), patients with a higher LMR14 (≥ 5) fared better than those with lower LMR14 (5-year OS, 83.3% vs. 46.3%, P=0.04).
Conclusion
In addition to pretreatment lymphocyte count, LMR during chemotherapy had prognostic significance in pediatric osteosarcoma patients. Further studies involving larger cohorts are necessary to validate our findings.
Key Words: Osteosarcoma, Lymphocyte, Monocyte, Ratio, Treatment outcome
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