THE PROGNOSTIC SIGNIFICANCE OF NEUTROPHIL-TOLYMPHOCYTE RATIO PATIENTS WITH LYMPHOMA

Öz

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.

Anahtar Kelimeler

• Hodgkin lymphoma
• Non-hodgkin lymphoma
• Neutrophil/ lymphocyte ratio
• Prognosis

LENFOMA HASTALARINDA NÖTROFİL LENFOSİT ORANININ PROGNOSTİK ÖNEMİ

Öz

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.

Anahtar Kelimeler

• Hodgkin lenfoma
• Non-hodgkin lenfoma
• Nötrofil/Lenfosit oranı
• Prognoz

Kaynakça

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