Elevated absolute monocyte count predicts unfavorable outcomes in patients with angioimmunoblastic T-cell lymphoma

• Higher AMC was observed in AITL patients with EBV infection.
• The best AMC cut-off level at diagnosis was 0.8 × 109/L for discriminating overall survival.
• AMC is an independent prognostic parameter for survival in patients with AITL.

This study was aimed at investigating the prognostic significance of the absolute monocyte count (AMC) in peripheral blood in patients with newly diagnosed angioimmunoblastic T cell lymphoma (AITL). AMC was performed in 73 therapy-naive patients with AITL in 2 institutions during 2008–2015, and higher AMC was observed in those with extranodal sites >1, bone marrow involvement, high lactate dehydrogenase level, the EBV infection, no response to treatment and high IPI, PIT, PIAI score group. The best AMC cut-off level at diagnosis was 0.8 × 109/L and the 3-year overall survival (OS) was 64% for patients with low AMC group (≤0.8 × 109/L) compared to 10% in high AMC group (>0.8 × 109/L) (P < 0.001). Multivariate analysis showed that elevated AMC remained an adverse prognostic parameter. Our results suggest that AMC is an independent prognostic parameter for OS in patients with AITL, and AMC >0.8 × 109/L can routinely be used to identify high-risk patients with unfavorable survival.