Journal List > Kosin Med J > v.31(2) > 1057065

Park, Lee, Lee, Shin, and Kim: Prognostic Significance of Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio in Diffuse Large B-Cell Lymphoma Patients Treated with R-CHOP

Abstract

Objectives

The both values of neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) were reported as indexes of systemic inflammation and readily available and inexpensive prognostic markers in patients with solid cancer. The objective of this study was to clarify whether the NLR and PLR were significant prognostic markers in Korean diffuse large B-cell lymphoma (DLBCL) patients treated with R-CHOP as a first line therapy.

Methods

: We retrospectively collected the clinical data of ninety nine DLBCL patients treated with R-CHOP from 2004 to 2012 and analyzed. NLR and PLR were calculated from complete blood count (CBC) and differential leukocyte count.

Results

: In univariate analysis, NLR was significantly associated with 5-year progression free survival(PFS) rate (P= 0.039), but not significantly associated with 5-year overal survival (OS) rate (P= 0.276). PLR was not significantly associated with 5-year PFS (P= 0.632) and OS rate (P= 0.855). In multivariate analysis, NLR was not a significant independent prognostic factor for 5-year PFS (P= 0.415) and OS rate (P= 0.991).

Conclusion

: The NLR can be considered a useful predictor of survival outcome. The PLR is not a valid predictor of survival outcome.

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Fig. 1.
Five years progression free survival curves and overall survival curves according to Neutrphil/lymphocyte ratio in patients with diffuse large B-cell lymphoma. a. Five years progression free survival curves b. Five years overall survival curves
kmj-31-122f1.tif
Fig. 2.
Five years progression free survival curves and overall survival curves according to Platelet/lymphocyte ratio in patients with diffuse large B-cell lymphoma. a. Five years progression free survival curves b. Five years overall survival curves
kmj-31-122f2.tif
Table 1.
Patient characteristics
Value (%) N=99
Age, years Median (range) 60 (32—81)
Gender (%) Male Female 53 (53.5) 46 (465%
IPI (%) Low Low-intermediate High-intermediate High 37 (37.4) 28 (28.3) 13 (13.1) 21 (21.2)
LDH Normal PIqude 39 (39.4) m (60 6\
ECOG (%) 0 — 1 > 7. 61 (61.6) 28 (18M
Stage (%) < 111 2 III 46 (46.5) 53 (53.5)
Extranodal involvement (%) < 2 > 7 84 (84.8) 14″ R″N
Bulky mass (%) < 10 cm 2 10 cm 88 (88.9) 11 (11.1)
CRP, mg/dL Mean (range) 2.25 (0.01 — 19.151
B2-microglobulin, mg/L Mean (ran 9e} 2.45 (0.87 — 9.6m
BM involvement (%) Present Absent 16(16.2) 2? (mm
ALC, x 103/mL Mean (range) I770 (40 — 2236M
Ferritin, ng/mL Mean (range) 334.76 (7.90 — 4872.40)
Neut/lymph ratio Mean (range) 3.53 (0.05 — 31.85)
PLT/lymph ratio Mean (range) 302.52 (12.61 — 7100.00)

IPI, international prognostic index; LDH, lactate dehydrogenase; ECOG, Eastern Cooperative Oncology Group (ECOG) oerformance status: CRP. C-reactive Drotein: BM. bone marrow: ALC. absolute lvmohocvte counts:

Table 2.
Prognostic factors for survival in patients with DLBCL by univariate analysis
Value Syrs PFS (%) P-Value Syrs OS (%) P-Value
Age, yrs < 60 > 60 71.6 67 7 0.094 70.8 66 4 0.231
Gender Male Female 66.8 65.5 0.472 63.2 72.2 0.265
IPI Low/low-intermediate Hi 0h-inf9fin9dintP/hi oh 73.8 en a 0005∗ 75.3 «I 1 0001∗
LDH, (IU/L) < 450 > A 4n 74.0 £1 < 0.119 82.3 (A 7 0.008∗
ECOG (%) < 2 > 2 70.1 57.5 0.322 73.6 65.9 0.809
Stage (%) < 111 2 III 82.5 51.4 0014∗ 85.9 50.5 0007∗
Extranodal involvement (0/: < 2 > 7. 65.3 710 0.529 67.3 658 0.926
Bulky mass (%) < 10 cm 210 cm 67.3 62.3 0.858 68.4 62.2 0.770
CRP, mg/dL < 0.8 > n 52 81.8 <76 0005∗ 82.9 H 7 0001∗
BZ-microglobulin, mg/L < 2.5 > 7 < 74.7 m 7 < 0.001" 77.8 M 1 0.001∗
BM involvement (%) Present Absent 47.7 69.8 0045∗ 49.7 71.5 0.164
ALC, 1.0 x105/uL < 1000 2 1000 69.4 67.6 0.696 81.5 65.0 0.390
Ferritin, ng/ml < 500 > €00 70.3 $1 2 0024∗ 72.3 46 7 0.004∗
Neut/lymph ratio < 3.50 > 3.50 67.9 51.7 0039∗ 71.1 63.0 0.276
PLT/lympho ratio < 150 150∼3 00 > 300 70.8 67.7 60.1 0.632 67.7 71.4 65.0 0.855

IPI, international prognostic index;LDH, lactate dehydrogenase; ECOG, Eastern Cooperative Oncology Grou (ECOG) nerformance statuszCRP. C-reactive nrotein: BM. bone marrow: ALC. absolute lvmnhocvte counts

Table 3.
Independent prognostic factors for survival in patients with DLBCL by multivariate analysis
Value PFS OS
RR 95% Cl p-value RR 95% Cl p-value
IPI Low & low-intennediate 0 R70 0 746–201? 0 217 n 600 0711—7 745% 0 S20
Hinwh-intennediate X; high
CRP, mg/dL < 0.8 > 0 R I 107, 0 781–479? 0 289 0591 OHSJSQ') 048$
BZ-microglobulin, mg/L < 2.5 2 2.5 0.195 0064–0595 0004∗ 0.285 0087–0936 0039∗
BM involvement (%) Present Absent 1.637 0.442—6063 0.461      
F erritin, ng/mL < 500 > 500 0.434 0.118-l.601 0.210 0.458 0.146–1.438 0.181
Neut/lympho ratio < 3.50 2 3.50 0.619 0.195–1.96C 0.415 0.987 0333–2948 0.991
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