title: The derived neutrophil to lymphocyte ratio is an independent prognostic factor in patients with diffuse large B-cell lymphoma.
abstract: BACKGROUND
  With growing evidence on the role of inflammation in cancer biology, the systemic inflammatory response has been postulated as having prognostic significance in a wide range of different cancer types. Recently, the derived neutrophil to lymphocyte ratio (dNLR) has been proposed as an easily determinable prognostic factor in cancer patients. Nevertheless, its prognostic significance in diffuse large B-cell lymphoma (DLBCL) patients has never been explored.
  
  
  METHODS
  Data from 290 consecutive DLBCL patients, diagnosed between 2004 and 2013 at a single Austrian centre, were evaluated retrospectively. The prognostic influence of the dNLR and other clinico-pathological factors including age, lactate dehydrogenase, cell of origin category and Ann Arbor stage on 5-year overall- (OS) and disease-free (DFS) survival was studied by Kaplan-Meier curves. To evaluate the independent prognostic relevance of dNLR, univariate and multivariate Cox regression models were applied.
  
  
  RESULTS
  An independent significant association between high dNLR and poor clinical outcome in multivariate analysis for OS (HR=2.02, confidence interval (CI) 95%=1.17-3.50, P=0.011), as well as DFS (HR=2.15, CI 95%=1.04-4.47, P=0.038), was identified.
  
  
  CONCLUSIONS
  In the present study, we showed that a high dNLR at diagnosis of DLBCL represents an independent poor prognostic factor for clinical outcome. Our data encourage the further validation of this easily available parameter in prospective studies and as a potential stratification tool in clinical trials.
authors.affiliation: Division of Hematology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria.
authors.forename: K
authors.initials: K
authors.lastname: Troppan
authors.affiliation: Division of Hematology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria.
authors.forename: A
authors.initials: A
authors.lastname: Deutsch
authors.affiliation: Division of Oncology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria.
authors.forename: A
authors.initials: A
authors.lastname: Gerger
authors.affiliation: Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz (MUG), Graz, Austria.
authors.forename: T
authors.initials: T
authors.lastname: Stojakovic
authors.affiliation: Institute of Pathology, Medical University of Graz (MUG), Graz, Austria.
authors.forename: C
authors.initials: C
authors.lastname: Beham-Schmid
authors.affiliation: Division of Hematology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria.
authors.forename: K
authors.initials: K
authors.lastname: Wenzl
authors.affiliation: Division of Hematology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria.
authors.forename: P
authors.initials: P
authors.lastname: Neumeister
authors.affiliation: Division of Oncology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Pichler
mesh_terms: D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000473:pathology; D008214:Lymphocytes / Q000473:pathology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000097:blood* / Q000175:diagnosis / Q000473:pathology; D008297:Male; D009504:Neutrophils / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies