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THE PROGNOSTIC SIGNIFICANCE OF NEUTROPHIL-TOLYMPHOCYTE RATIO PATIENTS WITH LYMPHOMA

Year 2021, Volume: 84 Issue: 1, 40 - 47, 15.01.2021
https://doi.org/10.26650/IUITFD.2020.0044

Abstract

Objective: The neutrophil-to-lymphocyte ratio (NLR) has been recently proposed as a simple, inexpensive prognostic factor in cancer patients. We aimed to investigate the prognostic meaning of pretreatment NLR in patients with lymphoma. Material and Method: Patients aged over 18 years with lymphoma who were diagnosed, followed-up and treated between January 2011 and December 2017 in the department of internal medicine were enrolled in this study. The data of 82 patients (62 NHL and 20 HL) were obtained retrospectively. The relationship between the NLR and baseline characteristics, laboratory parameters, prognosis, and survival outcome were evaluated. Results: In patients with HL, the older age group of the patients at the time of diagnosis had a high mortality rate and pleural effusion had a significant negative effect on OS (p=0.008, p=0.035). In patients with NHL, an advanced age, high IPI score, decreased PLT level and elevated beta 2 microglobulin were associated with a high mortality rate (p=0.001, p=0.044, p=0.023, p=0.009). Conclusion: A relation between the NLR and mortality and OS could be not demonstrated in HL patients and NHL patients. The retrospective analysis with a small sample size, late-diagnosed patients population and single-centre study may be the causes of these unexpected results.

References

  • 1. Caponetti G, Bagg A. Demystifying the diagnosis and classification of lymphoma: a hematologist/oncologist’s guide to the hematopathologist’s galaxy. JCSO 2017;15(1):43-8. [CrossRef]
  • 2. Swerdlow SH, Campo E, Pileri SA, Harris NL, Stein H, Siebert R, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood 2016;127(20):2375. [CrossRef]
  • 3. Kasper DL, Fauci AS, Longo DL, Hauser SL, Jameson JL, Loscalzo J editors. Harrison’s principles of internal medicine. Mc Graw Hill Education. 19th edition. 2018.
  • 4. Troppan K, Deutsch A, Gerger A, Stojakovic T, Beham- Schmid C, Wenzl K, et al. The derived neutrophil to lymphocyte ratio is an independent prognostic factor in patients with diffuse large B-cell lymphoma. Br J Cancer 2014;110(2):369-74. [CrossRef]
  • 5. Porrata LF, Ristow K, Habermann T, Inwards DJ, Micallef IN, Markovic SN. Predicting survival for diffuse large B-cell lymphoma patients using baseline neutrophil/lymphocyte ratio. Am J Hematol 2010;85(11):896-9. [CrossRef]
  • 6. Koh YW, Kang HJ, Park C, Yoon DH, Kim S, Suh C, et al. Prognostic significance of the ratio of absolute neutrophil count to absolute lymphocyte count in classic Hodgkin lymphoma. Am J Clin Pathol 2012;138(6):846-54. [CrossRef]
  • 7. Yüksel S. Non-hodgkin lenfoma olgularımızın klinik, patolojik, prognostik özelliklerinin ve tedavi sonuçlarının değerlendirilmesi (dissertation). Sarı H. İ.: Pamukkale Üniversitesi 2011.
  • 8. Kılıçkap S, Barışta İ, Ülger Ş, Çelik İ, Selek U, Yıldız F, et al. Clinical features and prognostic factors of hodgkin’s lymphoma: a single center experience. Balkan Med J 2013;2013(2):178-85. [CrossRef]
  • 9. Şeker M, Mengi A, Bilici A, Ustaalioğlu BB, Kefeli U, Özşeker NI, et al. Hodgkin lenfoma olgularının retrospektif değerlendirilmesi ve prognostik faktörlerin saptanması. Türk Onkoloji Dergisi 2011;26(3):108-14.
  • 10. Nakayama S, Matsuda M, Adachi T, Sueda S, Ohashi Y, Awaji S, et al. Novel prognostic index based on hemoglobin level and platelet count for diffuse large B-cell lymphoma, not otherwise specified in the R-CHOP era. Platelets 2019;30(5):637-45. [CrossRef]
  • 11. Bayram I, Erbey F, Komur M, Ozcan K, Karagoz D, Tunali N, et al. Treatment Results of non-Hodgkin’s Lymphoma Cases in Çukurova Region of Turkey. Erciyes Tıp Dergisi 2011;33(1):23-8.
  • 12. Suh C, Kim SH, Kim HJ, Jang G, Kim EK, Ko OB, et al. Prognostic factors in non-Hodgkin’s lymphoma patients treated by autologous stem cell transplantation: a single center experience. Cancer Res Treat 2005;37(5):294-301. [CrossRef]
  • 13. Zhao P, Zang L, Zhang X, Chen Y, Yue Z, Yang H, et al. Novel prognostic scoring system for diffuse large B-cell lymphoma. Oncol Lett 2018;15(4):5325-32. [CrossRef]
  • 14. Marcheselli R, Bari A, Tadmor T, Marcheselli L, Cox MC, Pozzi S, et al. Neutrophil-lymphocyte ratio at diagnosis is an independent prognostic factor in patients with nodular sclerosis Hodgkin lymphoma: results of a large multicenter study involving 990 patients. Hematol Oncol 2017;35(4):561- 6. [CrossRef]
  • 15. Romano A, Parrinello NL, Vetro C, Chiarenza A, Cerchione C, Ippolito M, et al. Prognostic meaning of neutrophil to lymphocyte ratio (NLR) and lymphocyte to monocyte ration (LMR) in newly diagnosed Hodgkin lymphoma patients treated upfront with a PET-2 based strategy. Ann Hematol 2018;97(6):1009-18. [CrossRef]
  • 16. Aslan C, Eren R, Doğu MH, Yokuş O, Suyanı E. Relationship between neutrophil-lymphocyte ratio and clinicopathological parameters in follicular lymphoma. IMJ 2016;17(4):150-1. [CrossRef]
  • 17. Smolewski P, Robak T, Krykowski E, Blasiñska-Morawiec M, Niewiadomska H, Pluzanska A, et al. Prognostic factors in Hodgkin’s disease: multivariate analysis of 327 patients from a single institution. Clin Canser Res 2000;6(3):1150-60.
  • 18. Cecyn KZ, Oliveira JSRd, Alves AC, Silva MRR, Kerbauy J. Prognostic factors in non-Hodgkin lymphomas. Sao Paulo Med J 2000;118(1):7-12. [CrossRef]
  • 19. Jiang JN, Sun XHJBR. The prognosis factors research on the 172 non-Hodgkin lymphoma cases. Biomedical Research 2016;27(2):336-44.
  • 20. Tabakan F, Nayir E, Arican AJTERJ. Clinical and pathological evaluation of histopathological subtypes in patients with non-Hodgkin’s Lymphoma. The European Research Journal 2016;2(1):52-61. [CrossRef]
  • 21. Li M, Xia H, Zheng H, Li Y, Liu J, Hu L, et al. Red blood cell distribution width and platelet counts are independent prognostic factors and improve the predictive ability of IPI score in diffuse large B-cell lymphoma patients. BMC Cancer 2019;19(1):1084. [CrossRef]
  • 22. Choi M, Lee J-O, Jung J, Lee JY, Lee E, Lee H, et al. Prognostic Value of Platelet Count in Patients with Peripheral T Cell Lymphoma. Acta Haematol 2019;141(3):176-86. [CrossRef]
  • 23. Reddy JP, Hernandez M, Gunther JR, Dabaja BS, Martin GV, Jiang W, et al. Pre-treatment neutrophil/lymphocyte ratio and platelet/lymphocyte ratio are prognostic of progression in early stage classical Hodgkin lymphoma. Br J Haematol 2018;180(4):545-9. [CrossRef]
  • 24. Yang M, Ping L, Liu W, Xie Y, Aliya, Liu Y, et al. Clinical characteristics and prognostic factors of primary extranodal classical Hodgkin lymphoma: a retrospective study. Hematology 2019;24(1):413-9. [CrossRef]
  • 25. Cánovas A, Alonso JJ, Barreiro G, Aguirre C. Prognostic factors in follicular lymphoma: the importance of beta-2 microglobulin. Tumori 2010;96(1):117-21. [CrossRef]

LENFOMA HASTALARINDA NÖTROFİL LENFOSİT ORANININ PROGNOSTİK ÖNEMİ

Year 2021, Volume: 84 Issue: 1, 40 - 47, 15.01.2021
https://doi.org/10.26650/IUITFD.2020.0044

Abstract

Amaç: Sistemik inflamasyon göstergesi olan nötrofil-lenfosit oranı (NLR), kanser hastalarında son zamanlarda önerilen basit ve ucuz bir prognostik faktördür. Çalışmamızda, tedavi öncesi yüksek NLR değerinin lenfoma hastalarında kötü sağkalımı gösterdiği hipotezine dayanarak lenfoma hastalarında tedavi öncesi NLR değerlerinin geriye dönük prognostik anlamını inceledik. Gereç ve Yöntem: Çalışmamıza Ocak 2011 ve Aralık 2017 tarihleri arasında İstanbul Tıp Fakültesi iç hastalıkları ve geriatri bölümünde tanı konulan, takip ve tedavi edilmiş 18 yaş üstü lenfoma tanılı hastalar dahil edildi. Sekseniki hastanın verileri retrospektif olarak hastane otomasyon sistemlerinden elde edildi. NLR ve temel karakteristikleri laboratuar parametreleri, prognoz ve sağkalım sonuçları arasındaki ilişki değerlendirildi. Bulgular: HL hastalarında, tanı anında daha ileri yaş grubundaki hastalarda yüksek mortalite hızı ve plevral efüzyonun varlığı uzun dönem sağkalım üzerine anlamlı negatif etkiye sahipti (p=0,008, p=0,035). NHL hastalarında, ileri yaş yüksek IPI skoru, düşük PLT seviyesi ve yüksek beta 2 mikroglobulin düzeyi yüksek mortalite oranıyla ilişkili bulundu (p=0,001, p=0,044, p=0,023, p=0,009). Sonuç: HL ve NHL hastalarında NLR ile mortalite ve uzun dönem sağkalım arasında bir ilişki gösterilememiştir. Bu retrospektif analizin küçük bir örneklem büyüklüğüne sahip olması, geç tanı konulmuş hasta popülasyonu ve tek merkezli bir çalışma olması bu beklenmedik sonucun nedeni olabilir.

References

  • 1. Caponetti G, Bagg A. Demystifying the diagnosis and classification of lymphoma: a hematologist/oncologist’s guide to the hematopathologist’s galaxy. JCSO 2017;15(1):43-8. [CrossRef]
  • 2. Swerdlow SH, Campo E, Pileri SA, Harris NL, Stein H, Siebert R, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood 2016;127(20):2375. [CrossRef]
  • 3. Kasper DL, Fauci AS, Longo DL, Hauser SL, Jameson JL, Loscalzo J editors. Harrison’s principles of internal medicine. Mc Graw Hill Education. 19th edition. 2018.
  • 4. Troppan K, Deutsch A, Gerger A, Stojakovic T, Beham- Schmid C, Wenzl K, et al. The derived neutrophil to lymphocyte ratio is an independent prognostic factor in patients with diffuse large B-cell lymphoma. Br J Cancer 2014;110(2):369-74. [CrossRef]
  • 5. Porrata LF, Ristow K, Habermann T, Inwards DJ, Micallef IN, Markovic SN. Predicting survival for diffuse large B-cell lymphoma patients using baseline neutrophil/lymphocyte ratio. Am J Hematol 2010;85(11):896-9. [CrossRef]
  • 6. Koh YW, Kang HJ, Park C, Yoon DH, Kim S, Suh C, et al. Prognostic significance of the ratio of absolute neutrophil count to absolute lymphocyte count in classic Hodgkin lymphoma. Am J Clin Pathol 2012;138(6):846-54. [CrossRef]
  • 7. Yüksel S. Non-hodgkin lenfoma olgularımızın klinik, patolojik, prognostik özelliklerinin ve tedavi sonuçlarının değerlendirilmesi (dissertation). Sarı H. İ.: Pamukkale Üniversitesi 2011.
  • 8. Kılıçkap S, Barışta İ, Ülger Ş, Çelik İ, Selek U, Yıldız F, et al. Clinical features and prognostic factors of hodgkin’s lymphoma: a single center experience. Balkan Med J 2013;2013(2):178-85. [CrossRef]
  • 9. Şeker M, Mengi A, Bilici A, Ustaalioğlu BB, Kefeli U, Özşeker NI, et al. Hodgkin lenfoma olgularının retrospektif değerlendirilmesi ve prognostik faktörlerin saptanması. Türk Onkoloji Dergisi 2011;26(3):108-14.
  • 10. Nakayama S, Matsuda M, Adachi T, Sueda S, Ohashi Y, Awaji S, et al. Novel prognostic index based on hemoglobin level and platelet count for diffuse large B-cell lymphoma, not otherwise specified in the R-CHOP era. Platelets 2019;30(5):637-45. [CrossRef]
  • 11. Bayram I, Erbey F, Komur M, Ozcan K, Karagoz D, Tunali N, et al. Treatment Results of non-Hodgkin’s Lymphoma Cases in Çukurova Region of Turkey. Erciyes Tıp Dergisi 2011;33(1):23-8.
  • 12. Suh C, Kim SH, Kim HJ, Jang G, Kim EK, Ko OB, et al. Prognostic factors in non-Hodgkin’s lymphoma patients treated by autologous stem cell transplantation: a single center experience. Cancer Res Treat 2005;37(5):294-301. [CrossRef]
  • 13. Zhao P, Zang L, Zhang X, Chen Y, Yue Z, Yang H, et al. Novel prognostic scoring system for diffuse large B-cell lymphoma. Oncol Lett 2018;15(4):5325-32. [CrossRef]
  • 14. Marcheselli R, Bari A, Tadmor T, Marcheselli L, Cox MC, Pozzi S, et al. Neutrophil-lymphocyte ratio at diagnosis is an independent prognostic factor in patients with nodular sclerosis Hodgkin lymphoma: results of a large multicenter study involving 990 patients. Hematol Oncol 2017;35(4):561- 6. [CrossRef]
  • 15. Romano A, Parrinello NL, Vetro C, Chiarenza A, Cerchione C, Ippolito M, et al. Prognostic meaning of neutrophil to lymphocyte ratio (NLR) and lymphocyte to monocyte ration (LMR) in newly diagnosed Hodgkin lymphoma patients treated upfront with a PET-2 based strategy. Ann Hematol 2018;97(6):1009-18. [CrossRef]
  • 16. Aslan C, Eren R, Doğu MH, Yokuş O, Suyanı E. Relationship between neutrophil-lymphocyte ratio and clinicopathological parameters in follicular lymphoma. IMJ 2016;17(4):150-1. [CrossRef]
  • 17. Smolewski P, Robak T, Krykowski E, Blasiñska-Morawiec M, Niewiadomska H, Pluzanska A, et al. Prognostic factors in Hodgkin’s disease: multivariate analysis of 327 patients from a single institution. Clin Canser Res 2000;6(3):1150-60.
  • 18. Cecyn KZ, Oliveira JSRd, Alves AC, Silva MRR, Kerbauy J. Prognostic factors in non-Hodgkin lymphomas. Sao Paulo Med J 2000;118(1):7-12. [CrossRef]
  • 19. Jiang JN, Sun XHJBR. The prognosis factors research on the 172 non-Hodgkin lymphoma cases. Biomedical Research 2016;27(2):336-44.
  • 20. Tabakan F, Nayir E, Arican AJTERJ. Clinical and pathological evaluation of histopathological subtypes in patients with non-Hodgkin’s Lymphoma. The European Research Journal 2016;2(1):52-61. [CrossRef]
  • 21. Li M, Xia H, Zheng H, Li Y, Liu J, Hu L, et al. Red blood cell distribution width and platelet counts are independent prognostic factors and improve the predictive ability of IPI score in diffuse large B-cell lymphoma patients. BMC Cancer 2019;19(1):1084. [CrossRef]
  • 22. Choi M, Lee J-O, Jung J, Lee JY, Lee E, Lee H, et al. Prognostic Value of Platelet Count in Patients with Peripheral T Cell Lymphoma. Acta Haematol 2019;141(3):176-86. [CrossRef]
  • 23. Reddy JP, Hernandez M, Gunther JR, Dabaja BS, Martin GV, Jiang W, et al. Pre-treatment neutrophil/lymphocyte ratio and platelet/lymphocyte ratio are prognostic of progression in early stage classical Hodgkin lymphoma. Br J Haematol 2018;180(4):545-9. [CrossRef]
  • 24. Yang M, Ping L, Liu W, Xie Y, Aliya, Liu Y, et al. Clinical characteristics and prognostic factors of primary extranodal classical Hodgkin lymphoma: a retrospective study. Hematology 2019;24(1):413-9. [CrossRef]
  • 25. Cánovas A, Alonso JJ, Barreiro G, Aguirre C. Prognostic factors in follicular lymphoma: the importance of beta-2 microglobulin. Tumori 2010;96(1):117-21. [CrossRef]
There are 25 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section RESEARCH
Authors

Alpay Medetalibeyoğlu This is me 0000-0002-5829-9186

Merve Ateş This is me 0000-0003-1427-8786

Mustafa Altınkaynak This is me 0000-0002-7768-2746

Gazi Çapar This is me 0000-0002-9857-0962

Sena Bayrakdar This is me 0000-0002-4675-185X

Cemil Taşçıoğlu This is me 0000-0003-3808-6957

Publication Date January 15, 2021
Submission Date April 22, 2020
Published in Issue Year 2021 Volume: 84 Issue: 1

Cite

APA Medetalibeyoğlu, A., Ateş, M., Altınkaynak, M., Çapar, G., et al. (2021). THE PROGNOSTIC SIGNIFICANCE OF NEUTROPHIL-TOLYMPHOCYTE RATIO PATIENTS WITH LYMPHOMA. Journal of Istanbul Faculty of Medicine, 84(1), 40-47. https://doi.org/10.26650/IUITFD.2020.0044
AMA Medetalibeyoğlu A, Ateş M, Altınkaynak M, Çapar G, Bayrakdar S, Taşçıoğlu C. THE PROGNOSTIC SIGNIFICANCE OF NEUTROPHIL-TOLYMPHOCYTE RATIO PATIENTS WITH LYMPHOMA. İst Tıp Fak Derg. January 2021;84(1):40-47. doi:10.26650/IUITFD.2020.0044
Chicago Medetalibeyoğlu, Alpay, Merve Ateş, Mustafa Altınkaynak, Gazi Çapar, Sena Bayrakdar, and Cemil Taşçıoğlu. “THE PROGNOSTIC SIGNIFICANCE OF NEUTROPHIL-TOLYMPHOCYTE RATIO PATIENTS WITH LYMPHOMA”. Journal of Istanbul Faculty of Medicine 84, no. 1 (January 2021): 40-47. https://doi.org/10.26650/IUITFD.2020.0044.
EndNote Medetalibeyoğlu A, Ateş M, Altınkaynak M, Çapar G, Bayrakdar S, Taşçıoğlu C (January 1, 2021) THE PROGNOSTIC SIGNIFICANCE OF NEUTROPHIL-TOLYMPHOCYTE RATIO PATIENTS WITH LYMPHOMA. Journal of Istanbul Faculty of Medicine 84 1 40–47.
IEEE A. Medetalibeyoğlu, M. Ateş, M. Altınkaynak, G. Çapar, S. Bayrakdar, and C. Taşçıoğlu, “THE PROGNOSTIC SIGNIFICANCE OF NEUTROPHIL-TOLYMPHOCYTE RATIO PATIENTS WITH LYMPHOMA”, İst Tıp Fak Derg, vol. 84, no. 1, pp. 40–47, 2021, doi: 10.26650/IUITFD.2020.0044.
ISNAD Medetalibeyoğlu, Alpay et al. “THE PROGNOSTIC SIGNIFICANCE OF NEUTROPHIL-TOLYMPHOCYTE RATIO PATIENTS WITH LYMPHOMA”. Journal of Istanbul Faculty of Medicine 84/1 (January 2021), 40-47. https://doi.org/10.26650/IUITFD.2020.0044.
JAMA Medetalibeyoğlu A, Ateş M, Altınkaynak M, Çapar G, Bayrakdar S, Taşçıoğlu C. THE PROGNOSTIC SIGNIFICANCE OF NEUTROPHIL-TOLYMPHOCYTE RATIO PATIENTS WITH LYMPHOMA. İst Tıp Fak Derg. 2021;84:40–47.
MLA Medetalibeyoğlu, Alpay et al. “THE PROGNOSTIC SIGNIFICANCE OF NEUTROPHIL-TOLYMPHOCYTE RATIO PATIENTS WITH LYMPHOMA”. Journal of Istanbul Faculty of Medicine, vol. 84, no. 1, 2021, pp. 40-47, doi:10.26650/IUITFD.2020.0044.
Vancouver Medetalibeyoğlu A, Ateş M, Altınkaynak M, Çapar G, Bayrakdar S, Taşçıoğlu C. THE PROGNOSTIC SIGNIFICANCE OF NEUTROPHIL-TOLYMPHOCYTE RATIO PATIENTS WITH LYMPHOMA. İst Tıp Fak Derg. 2021;84(1):40-7.

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