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LMR was analyzed as a clinical biomarker by receiver\u2010operating characteristic (ROC) analysis and Harrell's <jats:italic>C<\/jats:italic>\u2010statistics. Patients were characterized by a median age of 61 years, International Prognostic Index (IPI) score of &gt;2 in 39%, and were treated with a rituximab\u2010containing chemotherapy in 66%. LMR proved strongly predictive for survival in patients treated with rituximab\u2010based programs, but not in those receiving chemotherapy alone. Additionally, an LMR value of \u22642.6 (as determined by ROC analysis) was associated with a worst performance status, a higher lactate dehydrogenase (LDH) level, an advanced clinical stage, and a higher IPI score (<jats:italic>P<\/jats:italic>\u2009=\u20090.000). In patients treated with rituximab\u2010supplemented chemotherapy programs, an LMR value of &lt;2.6 was found in most of the primary refractory patients (75%) which proved as the best cutoff to predict both response and survival (<jats:italic>P<\/jats:italic>\u2009=\u20090.018). Finally, multivariate analysis and Harrell's <jats:italic>C<\/jats:italic>\u2010statistics confirmed the IPI\u2010independent role of LMR on survival (<jats:italic>P<\/jats:italic>\u2009=\u20090.0000). In conclusion, LMR is a potent predictor of clinical response and survival in DLBCL treated with rituximab\u2010containing chemotherapy. Am. J. Hematol. 88:1062\u20131067, 2013.  \u00a9 2013 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ajh.23566","type":"journal-article","created":{"date-parts":[[2013,8,12]],"date-time":"2013-08-12T12:18:17Z","timestamp":1376309897000},"page":"1062-1067","source":"Crossref","is-referenced-by-count":57,"title":["The lymphocyte to monocyte ratio improves the IPI\u2010risk definition of diffuse large B\u2010cell lymphoma when rituximab is added to chemotherapy"],"prefix":"10.1002","volume":"88","author":[{"given":"Alessandro","family":"Rambaldi","sequence":"first","affiliation":[{"name":"Hematology and Bone Marrow Transplant Units of Azienda Ospedaliera Papa Giovanni XXIII Bergamo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Boschini","sequence":"additional","affiliation":[{"name":"Hematology and Bone Marrow Transplant Units of Azienda Ospedaliera Papa Giovanni XXIII Bergamo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Gritti","sequence":"additional","affiliation":[{"name":"Hematology and Bone Marrow Transplant Units of Azienda Ospedaliera Papa Giovanni XXIII Bergamo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Delaini","sequence":"additional","affiliation":[{"name":"Hematology and Bone Marrow Transplant Units of Azienda Ospedaliera Papa Giovanni XXIII Bergamo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Oldani","sequence":"additional","affiliation":[{"name":"Hematology and Bone Marrow Transplant Units of Azienda Ospedaliera Papa Giovanni XXIII Bergamo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Rossi","sequence":"additional","affiliation":[{"name":"Hematology and Bone Marrow Transplant Units of Azienda Ospedaliera Papa Giovanni XXIII Bergamo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Maria","family":"Barbui","sequence":"additional","affiliation":[{"name":"Hematology and Bone Marrow Transplant Units of Azienda Ospedaliera Papa Giovanni XXIII Bergamo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Caracciolo","sequence":"additional","affiliation":[{"name":"Division of Hematology I University of Torino Torino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Ladetto","sequence":"additional","affiliation":[{"name":"Division of Hematology I University of Torino Torino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Gueli","sequence":"additional","affiliation":[{"name":"Hematology and Cell Therapy Division and Molecular Biotechnology Center Mauriziano\u2010Umberto I Hospital and Dep. 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