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Liu X, Bai Y, Liu Y, Li W, Cui Y, Xu J, Xiao X, Niu X, Sun K. Correlation between red blood cell distribution width/platelet count and prognosis of newly diagnosed diffuse large B-cell lymphoma. Blood Res 2023; 58:187-193. [PMID: 38031470 PMCID: PMC10758632 DOI: 10.5045/br.2023.2023156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/13/2023] [Accepted: 11/14/2023] [Indexed: 12/01/2023] Open
Abstract
Background Red blood cell distribution width/platelet count ratio (RPR) is a reliable prognostic assessment indicator for numerous diseases. However, no studies to date have examined the relationship between RPR and the prognosis of diffuse large B-cell lymphoma (DLBCL). Therefore, this study aimed to investigate the correlation between RPR and the clinical characteristics and prognosis of patients with diffuse large B-cell lymphoma. Methods We retrospectively studied 143 patients with newly diagnosed DLBCL and used the median value as the RPR threshold. We also investigated the correlation of pretreatment RPR level with clinical characteristics and its impact on DLBCL prognosis. Results Using the median value as the cut-off, patients with DLBCL were divided into a low RPR group (<0.0549) and a high RPR group (≥0.0549). Patients in the high RPR group were older, had a later Ann Arbor stage, were prone to bone marrow invasion, and had a higher National Comprehensive Cancer Network International Prognostic Index score (P<0.05). A survival analysis showed that progression-free survival (PFS) (P=0.003) and overall survival (OS) (P<0.0001) were significantly shorter in the high versus low RPR group. A multifactorial Cox analysis showed that bone marrow invasion and elevated lactate dehydrogenase (LDH) were separate risk factors for PFS (P<0.05), while an RPR ≥0.0549 and elevated LDH were separate risk factors for OS (P<0.05). Conclusion A high RPR (≥0.0549) in patients with newly diagnosed DLBCL is an independent risk factor for a poor prognosis.
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Affiliation(s)
- Xiaobo Liu
- Department of Hematology, Henan University People’s Hospital and Henan Provincial People’s Hospital, Zhengzhou, China
| | - Yanliang Bai
- Department of Hematology, Zhengzhou University People’s Hospital and Henan Provincial People’s Hospital, Zhengzhou, China
| | - Ying Liu
- Department of Hematology, Zhengzhou University People’s Hospital and Henan Provincial People’s Hospital, Zhengzhou, China
| | - Weiya Li
- Department of Hematology, Zhengzhou University People’s Hospital and Henan Provincial People’s Hospital, Zhengzhou, China
| | - Yabin Cui
- Department of Hematology, Henan University People’s Hospital and Henan Provincial People’s Hospital, Zhengzhou, China
| | - Jinhui Xu
- Department of Hematology, Zhengzhou University People’s Hospital and Henan Provincial People’s Hospital, Zhengzhou, China
| | - Xingjun Xiao
- Department of Hematology, Zhengzhou University People’s Hospital and Henan Provincial People’s Hospital, Zhengzhou, China
| | - Xiaona Niu
- Department of Hematology, Zhengzhou University People’s Hospital and Henan Provincial People’s Hospital, Zhengzhou, China
| | - Kai Sun
- Department of Hematology, Henan University People’s Hospital and Henan Provincial People’s Hospital, Zhengzhou, China
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Lisanti C, Basile D, Parnofiello A, Bertoli E, Andreotti VJ, Garattini SK, Bartoletti M, Cattaneo M, Di Nardo P, Bonotto M, Casagrande M, Da Ros L, Cinausero M, Foltran L, Pella N, Buonadonna A, Aprile G, Fasola G, Puglisi F. The SENECA study: Prognostic role of serum biomarkers in older patients with metastatic colorectal cancer. J Geriatr Oncol 2020; 11:1268-1273. [PMID: 32576519 DOI: 10.1016/j.jgo.2020.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/27/2020] [Accepted: 06/03/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Aging induces meaningful changes in the immune system and inflammation response with increase in monocyte-lymphocyte ratio (MLR) and serum lactate dehydrogenase (LDH) levels. Aim of this study was to explore the prognostic role of MLR and LDH levels in older patients (pts) with metastatic colorectal cancer (mCRC). METHODS We conducted a retrospective analysis of a consecutive cohort of 168 older (>70 years) patients with mCRC. The prognostic impact of MLR and LDH levels on overall survival (OS) was investigated through uni-and multivariate Cox regression analyses. Moreover, we categorized patients into three groups according to MLR and LDH levels (group 1: MLR-low and LDH-low; group 2: MLR-high or LDH-high; group 3: MLR-high and LDH-high). RESULTS By univariate analysis, high LDH level (HR 1.74, 95% CI 1.05-2.90) and high MLR level (HR 2.19, 95% CI 1.48-3.44) were significantly associated with a worse OS. Conversely, primary tumor resection and left-sidedness were significantly associated with a longer OS. By multivariate analysis, high LDH level (HR 2.00, 95% CI 1.13-3.55) and high MLR level (HR 2.99, 95% CI 1.68-5.33) were independent prognostic factors of worse prognosis. Compared to group 1, a shorter survival was reported for patients included in group 2 (HR 1.97, 95% CI 1.21-3.23 in univariate; HR 2.54, 95% CI 1.43-4.51 in multivariate) or in group 3 (HR 2.42, 95% CI 24-4.74, p = .010 in univariate; HR 5.59, 95% CI 2.15-14.54 in multivariate) CONCLUSIONS: High baseline levels of LDH, MLR or both are independent unfavorable prognostic factors in older patients treated with first-line chemotherapy for mCRC.
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Affiliation(s)
- Camilla Lisanti
- Department of Medicine (DAME), University of Udine, Udine, IT, Italy; Department of Medical Oncology, Unit of medical oncology and cancer prevention, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, IT, Italy
| | - Debora Basile
- Department of Medicine (DAME), University of Udine, Udine, IT, Italy; Department of Medical Oncology, Unit of medical oncology and cancer prevention, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, IT, Italy.
| | - Annamaria Parnofiello
- Department of Medicine (DAME), University of Udine, Udine, IT, Italy; Department of Medical Oncology, Unit of medical oncology and cancer prevention, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, IT, Italy
| | - Elisa Bertoli
- Department of Medicine (DAME), University of Udine, Udine, IT, Italy; Department of Oncology, ASUIUD Santa Maria della Misericordia, Udine, IT, Italy
| | - Victoria Josephine Andreotti
- Department of Medicine (DAME), University of Udine, Udine, IT, Italy; Department of Oncology, ASUIUD Santa Maria della Misericordia, Udine, IT, Italy
| | - Silvio Ken Garattini
- Department of Medicine (DAME), University of Udine, Udine, IT, Italy; Department of Oncology, ASUIUD Santa Maria della Misericordia, Udine, IT, Italy
| | - Michele Bartoletti
- Department of Medicine (DAME), University of Udine, Udine, IT, Italy; Department of Medical Oncology, Unit of medical oncology and cancer prevention, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, IT, Italy
| | - Monica Cattaneo
- Department of Medicine (DAME), University of Udine, Udine, IT, Italy; Department of Oncology, ASUIUD Santa Maria della Misericordia, Udine, IT, Italy
| | - Paola Di Nardo
- Department of Medical Oncology, Unit of medical oncology and cancer prevention, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, IT, Italy
| | - Marta Bonotto
- Department of Oncology, ASUIUD Santa Maria della Misericordia, Udine, IT, Italy
| | | | - Lucia Da Ros
- Department of Medical Oncology, Unit of medical oncology and cancer prevention, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, IT, Italy
| | - Marika Cinausero
- Department of Oncology, ASUIUD Santa Maria della Misericordia, Udine, IT, Italy
| | - Luisa Foltran
- Department of Medical Oncology, Unit of medical oncology and cancer prevention, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, IT, Italy
| | - Nicoletta Pella
- Department of Oncology, ASUIUD Santa Maria della Misericordia, Udine, IT, Italy
| | - Angela Buonadonna
- Department of Medical Oncology, Unit of medical oncology and cancer prevention, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, IT, Italy
| | - Giuseppe Aprile
- Department of Oncology, San Bortolo General Hospital, Azienda ULSS8 Berica, Vicenza, Italy
| | - Gianpiero Fasola
- Department of Oncology, ASUIUD Santa Maria della Misericordia, Udine, IT, Italy
| | - Fabio Puglisi
- Department of Medicine (DAME), University of Udine, Udine, IT, Italy; Department of Medical Oncology, Unit of medical oncology and cancer prevention, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, IT, Italy
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Wang Q, Huang T, Ji J, Wang H, Guo C, Sun X, Zheng K, Dong Z, Cao Y. Prognostic utility of the combination of pretreatment monocyte-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in patients with NMIBC after transurethral resection. Biomark Med 2019; 13:1543-1555. [PMID: 31621380 DOI: 10.2217/bmm-2019-0398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Aim: To investigate and validate predictive value of combination of pretreatment monocyte-to-lymphocyte ratio (MLR) and neutrophil-to-lymphocyte ratio (NLR) for disease free survival (DFS) and overall survival (OS) in nonmuscle invasive bladder cancer after transurethral resection. Materials & methods: Total 358 patients enrolled were assigned into three (MLR-NLR 0, 1 and 2) groups per the cut-off values of MLR and NLR. Results: Kaplan-Meier curves showed MLR, NLR and their combination were statistically associated with DFS (p < 0.001) and OS (p < 0.001). Univariate and multivariate COX regression analyses revealed that combination of MLR with NLR was an independent prognostic predictor for both DFS (HR: 3.080; 95% CI: 1.870-5.074; p < 0.001 for MLR-NLR 2 vs MLR-NLR 0) and OS (HR: 2.815; 95% CI: 1.778-4.456; p < 0.001 for MLR-NLR 2 vs MLR-NLR 0). Calibration plots and decision curve analysis exhibited combination of MLR and NLR had good calibration accuracy with potential clinical usefulness. Conclusion: Combined MLR and NLR is a prognostic predictive biomarker in nonmuscle invasive bladder cancer after transurethral resection.
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Affiliation(s)
- Qinghai Wang
- Department of Kidney Transplantation, The Affiliated Hospital of Qingdao University, Qingdao 266000, PR China
| | - Tao Huang
- Department of Kidney Transplantation, The Affiliated Hospital of Qingdao University, Qingdao 266000, PR China
| | - Jianlei Ji
- Department of Kidney Transplantation, The Affiliated Hospital of Qingdao University, Qingdao 266000, PR China
| | - Hongyang Wang
- Department of Kidney Transplantation, The Affiliated Hospital of Qingdao University, Qingdao 266000, PR China
| | - Chen Guo
- Department of Kidney Transplantation, The Affiliated Hospital of Qingdao University, Qingdao 266000, PR China
| | - Xiaoxia Sun
- Department of Kidney Transplantation, The Affiliated Hospital of Qingdao University, Qingdao 266000, PR China
| | - Kewen Zheng
- Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, The First Clinical College of Wenzhou Medical University, Wenzhou, Zhejiang 325000, PR China
| | - Zhen Dong
- Department of Kidney Transplantation, The Affiliated Hospital of Qingdao University, Qingdao 266000, PR China
| | - Yanwei Cao
- Department of Kidney Transplantation, The Affiliated Hospital of Qingdao University, Qingdao 266000, PR China
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Abstract
Mantle cell lymphoma (MCL) exhibits a heterogenous clinical course. The MCL International Prognostic Index (MIPI) is the most commonly used risk classification system in MCL. However, it does not contain a parameter associated with the tumor microenvironment. The aim of this study was to develop a more powerful prognostic index by evaluating the absolute monocyte count (AMC), neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR) at diagnosis in conjunction with the clinical and laboratory parameters.The data of 96 MCL patients with newly diagnosed from January 2014 to December 2018 were retrospectively evaluated in this study. The AMC, NLR, and PLR cut-off values were determined using the receiver operating characteristic (ROC) analysis.The clinical behavior and results of the disease exhibited significant variation in high and low value groups at the time of diagnosis. In univariate analysis, the AMC ≥ 580, NLR ≥ 2.43, and PLR ≥ 120.85 were determined as negative prognostic factors for 5-year progression free survival (PFS) (AMC: PFS, P < .001; NLR: PFS, P < .001; PLR: PFS, P < .001) and for 5-year overall survival (OS) (P < .001, P < .001, P < .001, respectively). Beta-2 microglobulin (B2-MG), and MIPI for PFS, and for OS were found to be independent risk factors in the multivariate analysis (for PFS: P = .006, P = .002, respectively; and for OS: P = .007, P = .001, respectively). The 5-year OS was 20% in the group with B2-MG ≥ 3.5. The patients in high-risk MIPI group had poorer 5-year OS (median OS: 40 months, P < .001).The results stated that the use of B2-MG in conjunction with MIPI was a more sensitive method in determining the prognosis in MCL (median OS: 12 months in high-risk MIPI group with a B2-MG ≥3.5, P < .001). Additionally, it was found that parameters reflecting the tumor microenvironment such as AMC, NLR, and PLR increased the risk of progression in MCL. In view of these findings, in addition B2-MG to the MIPI to create a more sensitive prognostic scoring system may provide an insight into personalization of treatment with early recognition of patients with poor prognosis.
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Yue W, Liu B, Gao L, He M, Wang J, Zhang W, Chen L, Hu X, Xu L, Yang J. The pretreatment albumin to globulin ratio as a significant predictor in patients with diffuse large B cell lymphoma. Clin Chim Acta 2018; 485:316-322. [PMID: 30006285 DOI: 10.1016/j.cca.2018.07.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/01/2018] [Accepted: 07/09/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND The pretreatment albumin to globulin ratio (AGR) has been used to predict survival in several types of tumors. However, whether AGR can predict outcomes in patients with diffuse large B-cell lymphoma (DLBCL) remains unclear. We evaluated the prognosis value of AGR in DLBCL patients. METHODS We retrospectively analyzed the available serum biochemical results of 335 patients with newly diagnosed DLBCL before treatment. The AGR was calculated as: albumin (g/L)/globulin. X-tile program was used to generate an optimal cut-off value of 1.3 for AGR. And all patients were respectively divided into the low AGR and high AGR groups according to the cut-off value. RESULTS The low AGR group displayed more adverse clinical chacteristics, including old age, sex (female), increased β2-microglobulinpoor (β2-MG), increased lactate dehydrogenase (LDH), B symptoms, poor performance status (PS), advanced stage, number of extranodal sites ≥ 2 and higher International Prognostic Index (IPI). AGR was negatively correlated with age, IPI score, ECOG score, Ann Arbor stage, B symptoms, β2-MG, LDH, and extranodal involvement, while positively correlated with gender. Patients with a low AGR presented with significantly poorer overall survival (OS, P = .001). Multivariate analysis further demonstrated that a low AGR was an independent adverse predictor for OS (HR = 0.613; 95% CI = 0.412-0.910, P = .015). In addition, AGR distinguished patients with different prognosis in stage III-IV and the non-germinal center B cell-like lymphoma (non-GCB) groups, a low AGR was also significantly associated with poor OS in 2 groups. CONCLUSION Pretreatment AGR was a simple and effective clinical marker of survival in patients with DLBCL, and may had an additional prognostic value based on Ann Arbor stage and cell of origin for DLBCL.
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Affiliation(s)
- Wenqin Yue
- Department of Hematology, Changhai Hospital, The Second Military Medical University, Shanghai 200433, China
| | - Bin Liu
- Department of Hematology, Changhai Hospital, The Second Military Medical University, Shanghai 200433, China
| | - Lei Gao
- Department of Hematology, Changhai Hospital, The Second Military Medical University, Shanghai 200433, China
| | - Miaoxia He
- Department of Pathology, Changhai Hospital, The Second Military Medical University, Shanghai 200433, CHINA
| | - Jianmin Wang
- Department of Hematology, Changhai Hospital, The Second Military Medical University, Shanghai 200433, China
| | - Weiping Zhang
- Department of Hematology, Changhai Hospital, The Second Military Medical University, Shanghai 200433, China
| | - Li Chen
- Department of Hematology, Changhai Hospital, The Second Military Medical University, Shanghai 200433, China
| | - Xiaoxia Hu
- Department of Hematology, Changhai Hospital, The Second Military Medical University, Shanghai 200433, China
| | - Lili Xu
- Department of Hematology, Changhai Hospital, The Second Military Medical University, Shanghai 200433, China.
| | - Jianmin Yang
- Department of Hematology, Changhai Hospital, The Second Military Medical University, Shanghai 200433, China.
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