Low platelet/platelet distribution width and high platelet/lymphocyte ratio are adverse prognostic factors in patients with newly diagnosed advanced Hodgkin lymphoma

Plateletcrit as a prognostic marker in Hodgkin lymphoma: A pilot study

Background/Aim: Hodgkin lymphoma (HL) is a lymphoproliferative malignancy associated with inflammation. Plateletcrit (PCT) is a mean platelet volume (MPV) and platelet count-derived marker that is useful for evaluating malignancies and inflammatory diseases. International Prognostic Score (IPS-7) and more recently, IPS-3, are two indices indicating the prognosis of patients; however, widespread and easy to interpret prognostic markers are still needed for HL evaluation. Very few studies evaluating the prognostic significance of platelet indices in HL have been published, so we aimed to show the relationship between PCT and other adverse prognostic factors in HL and evaluate whether PCT can be used as a prognostic marker in HL. Methods: After excluding patients with insufficient data, 75 patients diagnosed with HL and 150 healthy controls were retrospectively analyzed in this case-control study. Evaluation of relationship of PCT and adverse HL prognostic factors, such as age, gender, hemoglobin, leukocytes, lymphocytes (absolute value and percentage), albumin, Ann Arbor stage and B symptoms, IPS-3 and-7 prognostic scores and post-treatment relapse, and progression-free survival of the patients were studied. Results: Mean MPV values were significantly lower, mean platelet values were significantly higher inpatient group (all P<0.001). Patients with high sedimentation had significantly higher mean PCT than those without (P=0.031) and a moderately positive correlation between PCT and sedimentation were found (r=0.33, P<0.01). Mean PCT values after treatment significantly decreased compared to baseline levels (P<0.001). Conclusion: PCT may be useful as a prognostic marker in HL. Further studies were needed to evaluate the relationship between PCT and other prognostic factors, such as IPS-3 and -7.

A new prognostic model including platelet/lymphocyte ratio and International Prognostic Score 3 for freedom from progression in patients with previously untreated advanced classical Hodgkin lymphoma

PURPOSE

We aimed to develop a new risk stratification tool to predict freedom from progression (FFP) for newly diagnosed advanced classical Hodgkin lymphoma (cHL).

METHODS

We collected data from 386 patients with advanced cHL diagnosed between December 8, 2000 and October 29, 2018, and treated with curative intent with ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) or an ABVD-equivalent regimen. Cases were randomly divided into training and validation cohorts at a ratio of 7:3. The new model was constructed based on the results of Cox proportional hazards model in the training cohort. Comparisons of discrimination between the new model and other models in the training and validation cohorts for FFP prediction were measured by time-dependent area under curve (tAUC) and Harrell's C-index. Calibration plots were constructed to compare the consistency between the predicted and observed estimates of survival probability for the new model in the training and validation cohorts.

RESULTS

The new model (IPSPLR) composed of International Prognostic Score (IPS)-3 and platelet/lymphocyte ratio (PLR) provided four distinct risk groups. The IPSPLR showed better discriminative ability when compared with IPS-3 and IPS-7. The AUC of IPSPLR was consistently higher than that of IPS-3 and IPS-7 between 12 and 120 months. The C-index of the IPSPLR was higher than that of IPS-7 and IPS-3. The calibration plots showed an excellent agreement between the IPSPLR-predicted and observed estimates of 5-year FFP.

CONCLUSION

The IPSPLR is an easily used tool for FFP prediction for newly diagnosed advanced cHL. Validation of this tool in other large datasets is needed.

Prognostic role of red blood cell distribution width and platelet/lymphocyte ratio in early-stage classical Hodgkin lymphoma

Background: To investigate the prognostic role of red blood cell distribution width (RDW) and platelet/lymphocyte ratio (PLR) in early-stage classical Hodgkin lymphoma (cHL). Materials & methods: Data from 402 patients with newly diagnosed early-stage cHL were retrospectively collected. The impact of factors on complete response (CR) rate and freedom from progression (FFP) was analyzed. Results: High PLR was associated with lower CR, but high RDW was not. The univariate analysis showed that RDW and PLR were predictive of FFP. On multivariate analysis, high PLR was an independent risk factor for inferior FFP. Subgroup analysis and a prognostic model for FFP based on PLR validated the prognostic role of PLR. Conclusion: PLR was a robust prognostic factor for newly diagnosed early-stage cHL.