Purpose: To investigate the role of the absolute monocyte count (AMC) as a predictor of response to anticoagulation and survival in lung cancer patients with venous thromboembolism (VTE).
Methods: We retrospectively collected the clinical data of 134 patients with lung cancer who were diagnosed with VTE and treated with anticoagulation between July 2008 and May 2014 in a single institution. Baseline characteristics, laboratory findings, response to anticoagulation, and survival since the diagnosis of VTE were analyzed in low (n = 67) and high (n = 67) AMC groups according to median AMC (640/μL) at the time of VTE diagnosis.
Results: The majority of patients had non-small cell lung cancer (n = 110, 82.1%), stage IV (n = 86, 64.2%), and pulmonary thromboembolism (n = 102, 76.1%) and were incidentally diagnosed with VTE without any sign of thrombosis (n = 103, 76.9%). Patients’ characteristics and laboratory values were not significantly different between low and high AMC groups. Among 90 patients available for evaluation of response to anticoagulation, high AMC group (n = 10/46, 21.7%) was more refractory to anticoagulation than low AMC group (n = 3/44, 6.8%) (p = 0.044). In addition, high AMC group showed worse overall survival than low AMC group (median 9.6 vs. 5.9 months, p = 0.038). In multivariate analysis, high AMC and low albumin were independent poor prognostic factors.
Conclusion: High AMC is associated with refractoriness to anticoagulation and poor prognosis in lung cancer patients with VTE. Further evaluation is warranted to confirm these findings.
No relevant conflicts of interest to declare.
Asterisk with author names denotes non-ASH members.