Diffüz Büyük B Hücreli Lenfoma Tanılı Hastalarda Tanıdaki Tam Kan Parametrelerinin Prognostik Önemi

Öz

Amaç: Diffüz büyük b hücreli lenfoma DBBHL tanısı alan hastalarda tam kan sayımı ve ilişkili bileşenleri, prognozun belirlenmesinde basit, ucuz, kolaylıkla yorumlanabilen ve yaygın olarak kullanılan markerlardan biridir. Çalışmanın amacı, DBBHL hastalarında tam kan sayımı parametreleri ile ilişkili bileşenlerin prognostik rolünü değerlendirmektir. Gereç ve Yöntemler: Retrospektif olarak 2011-2017 yıllarında DBBHL tanısı almış ve toplam 6 kür R-CHOP kemoterapisi ile tedavi edilmiş hastaların tanıdaki nötrofil/lenfosit oranına NLR , lenfosit-monosit oranına LMR ve Platelet-lenfosit oranına PLR bakıldı ve progresyonsuz sağkalım PFS ve genel sağkalım OS analizi yapıldı. Bulgular: Çalışmaya 66 hasta dahil edildi. Cox-Regresyon Modelinde, yüksek NLR ve düşük LMR kısa OS ve PFS ile ilişkiliydi; yüksek PLR, kısa PSF ile ilişkiliydi.Sonuç: Çalışmamızın sonucunda tedavi öncesi NLR, LMR, PLR değerlerinin DBBHL hastalarında bağımsız prognostik faktör olarak kullanılabileceğini gösterir

Anahtar Kelimeler

• Nötrofil/lenfosit oranı, Lenfosit-monosit oranı, Platelet-lenfosit oranı, Diffüz

The Prognostic Value of Blood Count Parameters in Patients with Diffuse Large B Cell Lymphoma

Abstract

Objective: Full blood count with the associated components is a widely used marker in the diagnosis of patients with diffuse large B cell lymphoma DLBCL as it is simple and inexpensive and can be easily interpreted. The aim of the current study was to evaluate the prognostic role of complete blood count parameters with the associated components in patients with DLBCL.Material and Methods: In this retrospective study, the neutrophil/lymphocyte ratio NLR , lymphocyte/monocyte ratio LMR , and platelet/lymphocyte ratio PLR were evaluated and an analysis was made of the progression-free survival PFS and overall survival OS in patients who were diagnosed with DLBCL and treated with a total of 6 cycles of R-CHOP chemotherapy in the 2011-2017 period.Results: 66 patients were included in the study. In the Cox-Regression Model, high NLR and the low LMR were associated with short OS and PFS; high PLR was associated with short PSF.Conclusion: Pre-treatment NLR, LMR, and PLR values can be used as prognostic factors in DLBCL patients

Keywords

• Neutrophil/Lymphocyte ratio, Lymphocyte/Monocyte ratio, Platelet/Lymphocyte

Kaynakça

1. Cultrera JL, Dalia SM. Diffuse large B-cell lymphoma: Current strategies and future directions. Cancer Control 2012; 19(3):204-13.
2. Friedberg JW. Relapsed/refractory diffuse large B-cell lymphoma. Hematology Am Soc Hematol Educ Program 2011; 498-505.
3. Tilly H, Gomes da Silva M, Vitolo U, Jack A, Meignan M, Lopez-Guillermo A, Walewski J, André M, Johnson PW, Pfreundschuh M, Ladetto M. ESMO Guidelines Committee. Diffuse Large B-cell Lymphoma (DLBCL): ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2015; 5:116-25.
4. Bizjak M, Selmi C, Praprotnik S, Bruck O, Perricone C, Ehrenfeld M, Shoenfeld Y. Silicone implants and lymphoma: The role of inflammation. J Autoimmun 2015; 65:64-73.
5. Baecklund E, Smedby KE, Sutton LA, Askling J, Rosenquist R. Lymphoma development in patients with autoimmune and inflammatory disorders-what are the driving forces? Semin Cancer Biol 2014; 24:61-70.
6. Li ZM, Huang JJ, Xia Y, Sun J, Huang Y, Wang Y, Zhu YJ, Li YJ, Zhao W, Wei WX, Lin TY, Huang HQ, Jiang WQ. Blood lymphocyte-to-monocyte ratio identifies high- risk patients in diffuse large B-cell lymphoma treated with R-CHOP. PLoS One 2012; 7(7):e41658.
7. Aoki K, Tabata S, Yonetani N, Matsushita A, Ishikawa T. The prognostic impact of absolute lymphocyte and monocyte counts at diagnosis of diffuse large B-cell lymphoma in the rituximab era. Acta Haematol 2013; 130:242-6.
8. Koh YW, Park CS, Yoon DH, Suh C and Huh J. Should the cut-off values of the lymphocyte to monocyte ratio for prediction of prognosis in diffuse large B-cell lymphoma be changed in elderly patients? Eur J Haematol 2014; 93:340-8.

9. Wilcox RA, Ristow K, Habermann TM, Inwards DJ, Micallef IN, Johnston PB, Colgan JP, Nowakowski GS, Ansell SM, Witzig TE, Markovic SN, Porrata L. The absolute monocyte and lymphocyte prognostic score predicts survival and identifies high-risk patients in diffuse large- B-cell lymphoma. Leukemia 2011; 25:1502-9.
10. Porrata LF, Inwards DJ, Ansell SM, Micallef IN, Johnston PB, Hogan WJ, Markovic SN. Infused autograft lymphocyte to monocyte ratio and survival in diffuse large B cell lymphoma. Biol Blood Marrow Transplant 2014; 20:1804-12.
11. Watanabe R, Tomita N, Itabashi M, Ishibashi D, Yamamoto E, Koyama S, Miyashita K, Takahashi H, Nakajima Y, Hattori Y, Motohashi K, Takasaki H, Ohshima R, Hashimoto C, Yamazaki E, Fujimaki K, Sakai R, Fujisawa S, Motomura S, Ishigatsubo Y. Peripheral blood absolute lymphocyte/monocyte ratio as a useful prognostic factor in diffuse large B-cell lymphoma in the rituximab era. Eur J Haematol 2014; 92:204-10.
12. Wang J, Zhou M, Xu JY, Yang YG, Zhang QG, Zhou RF, Chen B, Ouyang J. Prognostic role of pretreatment neutrophil/lymphocyte ratio in patients with diffuse large B-cell lymphoma treated with RCHOP. Medicine (Baltimore) 2016; 95(38):e4893.
13. Zhao P, Zang L, Zhang X, Chen Y, Yang H, Zhao H, Yu Y, Wang Y, Zhang Y, Wang X. The lymphocyte- monocyte ratio and the platelet-lymphocyte ratio at diagnosis as independent prognostic factors in primary gastrointestinal diffuse large B cell lymphoma. Indian J Hematol Blood Transfus 2017; 33(3):333-41.
14. Ho CL, Lu CS, Chen JH, Chen YG, Huang TC, Wu YY. Neutrophil/lymphocyte ratio, lymphocyte/monocyte ratio, and absolute lymphocyte count/absolute monocyte count prognostic score in diffuse large B-Cell lymphoma: Useful prognostic tools in the rituximab era. Medicine (Baltimore) 2015; 94(24):e993.
15. Keam B, Ha H, Kim TM, Jeon YK, Lee SH, Kim DW, Kim CW, Heo DS. Neutrophil to lymphocyte ratio improves prognostic prediction of International Prognostic Index for patients with diffuse large B-cell lymphoma treated with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone. Leuk Lymphoma 2015; 56:2032-8.
16. Xia WK, Lin QF, Shen D, Liu ZL, Su J, Mao WD. Prognostic significance of lymphocyte-to-monocyte ratio in diffuse large B-cell lymphoma: A systematic review and meta-analysis. FEBS Open Bio 2016; 6(6):558-65.