Absolute monocyte count is a predictor of overall survival and progression-free survival in nodal peripheral T cell lymphoma

Nodal peripheral T cell lymphomas (nPTCL) present aggressive clinical course, and its heterogeneous nature and poor prognosis with current therapeutic strategies make it a target for the development of new prognostic markers. Thus, we investigated tumor-associated macrophages (TAM) according to the number of cells expressing CD68 in biopsies and the absolute monocyte count (AMC) in peripheral blood of 87 patients with nPTCL. The median overall survival (OS) was 3 years (95% CI 1.3-8.4 years) and estimate 5 years OS of 43.3% (95% CI 32.5-53.7%). The median progression-free survival (PFS) was 1.5 years (95% CI 0.8-2.6 years) with estimate 5 years PFS of 29.2% (95% CI 19.7-39.3%). The cutoff for AMC was 1.5 x 10(9)/L and the median OS for patients with AMC >= 1.5 x 10(9)/L was 0.83 years versus 3.7 years for those with AMC < 1.5 x 10(9)/L (HR 2.32, 95% CI 1.03-5.22, p = 0.035). The median PFS for patients with AMC >= 1.5 x 10(9)/L was 0.50 years versus 1.5 years for those with AMC < 1.5 x 10(9)/L (HR 2.25, 95% CI 1.05-4.78, p = 0.031). CD68 was evaluated in 26/87 (29.8%) patients with a median expression of 34% and positivity cutoff of 43%. CD68 expression was not associated with OS or PFS either with AMC values. Our findings suggest that the AMC of >= 1.5 x 10(9)/L at diagnosis in peripheral blood is associated with poor prognosis in nPTCL. Further investigations in a larger cohort are required to better validate our results.