Keywords
How to Cite
Abstract
Introduction. The Neutrophil/Lymphocyte Index may be a prognostic factor in patients with diffuse large B-cell lymphoma. Material and methods. Observational, retrospective, cross-sectional and analytical study. Eighty-three patients with diffuse large B-cell lymphoma, diagnosed between January 2014 and December 2018, were included. The descriptive analysis was done with absolute frequencies, percentages and measures of central tendency. The qualitative variables were analyzed with the chi-square test and the quantitative variables with the Student's T test. To evaluate association, the relative risk was measured with a 95% CI, with a p value <0.05% being significant. A survival analysis was performed with Kaplan-Meier curves. Results. Of 83 patients, 51 (61.4%) were men and 32 (38.5%) were women, with a median age of 61 (26-85) years and a median follow-up of 27 (0.9-73.2) months. Only 11 patients (27.5%) with INL ≥3 achieved a complete response.
Overall 6-year survival in this group was 36%. Conclusions. The elevated Neutrophil / Lymphocyte Index at diagnosis is associated with a worse response to first-line treatment with R-CHOP and a lower overall survival
References
Aiaenberg, AC. Historical review of lymphomas. Br. J. Haematol. 2000; 109(3):466-476.
Swerdlow SH, Campo E, Pileri SA y col. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016;127(20):2375-2390.
Diumenjo MC, Abriata G, Forman D y Sierra MS. The burden of non-Hodgkin lymphoma in Central and South America. Cancer Epidemiol. 2016; 44:S168–S177.
Forman D, Bray F, Brewster DH y col. Cancer Incidence in Five Continents: Inclusion criteria, highlights from Volume X and the global status of cancer registration. Int. J. Cancer. 2015; 137(9):2060-2071.
Ferlay, J. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int. J. Cancer. 2019; 144(8):1941-1953.
International Non-Hodgkin's Lymphoma Prognostic Factors Project. A predictive model for aggressive non-Hodgkin's lymphoma. N. Engl. J. Med. 1993; 329(14):987-994.
Sehn LH, Berry B, Chhanabhai, M y col. The revised International Prognostic Index (R-IPI) is a better predictor of outcome than the standard IPI for patients with diffuse large B-cell lymphoma treated with R-CHOP. Blood. 2007; 109(5):1857-1861.
Coiffier B, Lepage E, Briere J y col. CHOP Chemotherapy plus Rituximab Compared with CHOP Alone in Elderly Patients with Diffuse Large-B-Cell Lymphoma. N Engl J Med. 2002; 346:235-242
Tomita N, Takasaki H, Miyashita K, Fujisawa S, Ogusa E, Matsuura S. R-CHOP therapy alone in limited stage diffuse large B-cell lymphoma. Br J Haematol. 2013; 161(3):383-388.
Zelenetz AD y col. (coords.). NCCN Guidelines Insights: B-Cell Lymphomas, Version 3.2019: Featured Updates to the NCCN Guidelines. Journal of the National Comprehensive Cancer Network. 2019; 17(6):650-661.
Liu Y y Barta SK. Diffuse large B-cell lymphoma: 2019 update on diagnosis, risk stratification, and treatment. Am. J. Hematol. 2019; 94(5):604–616.
Cheson BD, Fisher RI, Barrington SF y col. Recommendations for initial evaluation, staging, and response assessment of hodgkin and non-hodgkin lymphoma: The Lugano classification. J. Clin. Oncol. 2014; 32(27):3059–3067.
Berraondo P, Minute L, Ajona D, Corrales L, Melero I, Pio R. Innate immune mediators in cáncer: between defenso and resistance. Immunol Rev. 2016; 274(1):290-306.
Kang MH, Go SI, Song HN y col. The Prognostic Impact of the Neutrophil-to-Lymphocyte Ratio in Patients with Small-Cell Lung Cancer. Br. J. Cancer. 2014; 111(3):452–460.
Proctor MJ, Morrison DS, Talwar D y col. A comparison of inflammation-based prognostic scores in patients with cancer. A Glasgow Inflammation Outcome Study. Eur. J. Cancer. 2011; 47(17):2633-2641.
Noh H, Eomm M, Han A. Usefulness of pretreatment neutrophil to lymphocyte ratio in predicting disease-specific survival in breast cancer patients. J Breast Cancer. 2013; 16(1):55–59.
Mu S, Ai L, Fan F, Qin Y, Sun C, Hu Y. Prognostic role of neutrophil-to-lymphocyte ratio in diffuse large B cell lymphoma patients: an updated dose–response meta-analysis. Cancer cell int. 2018; 18(1):119.
Porrata L, Ristow K, Habermann T, Inwards J, Micallef N, Markovic N. Predicting survival for diffuse large B-cell lymphoma patients using baseline neutrophil/lymphocyte ratio. Am. J. Hematol. 2010; 85(11):896-899.
Guthrie GJ, Charles KA, Roxburgh CS, Horgan PG, McMillan DC, Clarke SJ. The systemic inflammation-based neutrophil-lymphocyte ratio: Experience in patients with cancer. Crit Rev Onc. 2013; 88(1):218–230.
Lee SM, Russell A, Hellawell G. Predictive value of pretreatment inflammation-based prognostic scores (Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio) for invasive bladder carcinoma. Korean J Urol. 2015; 56(11):749–755.
Troppan K, Deutsch A, Gerger A y col. 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):369–374.
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. 2015; 94(24):e993.
Keam B, Ha H, Kimv TM y col. 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(7):2032–2038.
Wang J, Zhou M, Xu JY y col. Prognostic role of pretreatment neutrophil/lymphocyte ratio in patients with diffuse large B-cell lymphoma treated with RCHOP. Medicine. 2016; 95(38):1–5.
Go SI, Park S, Kim JH y col. A new prognostic model using the NCCN-IPI and neutrophil-to-lymphocyte ratio in diffuse large B-cell lymphoma. Tumori Journal, 2018; 104(4):292-299.
Go Wang S, Ma Y, Sun L y col. Prognostic Significance of Pretreatment Neutrophil/Lymphocyte Ratio and Platelet/Lymphocyte Ratio in Patients with Diffuse Large B-Cell Lymphoma. Biomed Res Int. 2018; 2018:9651254.
Azuma Y, Nakaya A, Fujita S y col. Neutrophil-to-lymphocyte ratio (NLR) fails to predict outcome of diffuse large B cell lymphoma. Leuk Res Rep. 2019; 12:100173.
Melchardt T, Troppan K, Weiss L y col. Independent prognostic value of serum markers in diffuse large B-cell lymphoma in the era of the NCCN-IPI. Journal of the National Comprehensive Cancer Network. 2015;13(12):1501-1508.
Beltrán BE, Paredes S, Cotrina E, Sotomayor EM y Castillo JJ. The impact of the neutrophil: lymphocyte ratio in response and survival of patients with de novo diffuse large B-cell lymphoma. Leukemia research, 2018; 67:82-85.
Annibali O, Hohaus S, Marchesi F y col. The neutrophil/lymphocyte ratio ≥3.5 is a prognostic marker in diffuse large B-cell lymphoma: a retrospective analysis from the database of the Italian regional network 'Rete Ematologica del Lazio per I Linfomi' (RELLI). Leuk Lymphoma. 2019; 60(14):3386-3394.
All material published in the journal HEMATOLOGÍA (electronic and print version) is transferred to the Argentinean Society of Hematology. In accordance with the copyright Act (Act 11 723), a copyright transfer form will be sent to the authors of approved works, which has to be signed by all the authors before its publication. Authors should keep a copy of the original since the journal is not responsible for damages or losses of the material that was submitted. Authors should send an electronic version to the email: revista@sah.org.ar