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.
The purpose of this study was to analyze the pre- and post-treatment neutrophil to lymphocyte ratio (pre- and post-NLR) in combination with immunologic profiles in patients with diffuse large B-cell lymphoma (DLBCL) treated with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP). A total of 447 newly diagnosed patients with DLBCL treated with R-CHOP were analyzed retrospectively. A pre-NLR ≥ 3 was independently associated with poor progression-free survival (PFS) (hazard ratio [HR] = 2.19, p < 0.001) and overall survival (OS) (HR = 2.89, p < 0.001). In patients with high pre-NLR, reduction of the post-NLR to < 3 after R-CHOP was correlated with improved survival. Low pre-NLR (< 3) was also associated with a higher number of peripheral CD19 + lymphocytes (p = 0.049) and NK cells (p = 0.031). In conclusion, a pre-NLR ≥ 3 was an independent prognostic factor for PFS and OS in patients with DLBCL treated with R-CHOP.
Department of Internal Medicine , Seoul National University Hospital, Seoul , Korea.
Bhumsuk
B
Keam
Hyerim
H
Ha
Tae Min
TM
Kim
Yoon Kyung
YK
Jeon
Se-Hoon
SH
Lee
Dong-Wan
DW
Kim
Chul Woo
CW
Kim
Dae Seog
DS
Heo
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008214:Lymphocytes / Q000473:pathology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009504:Neutrophils / Q000473:pathology*; D011241:Prednisone / Q000008:administration & dosage; D011379:Prognosis; D012189:Retrospective Studies; D000069283:Rituximab / Q000008:administration & dosage; D015996:Survival Rate; D014750:Vincristine / Q000008:administration & dosage; D055815:Young Adult
D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
Neutrophil to lymphocyte ratio; diffuse large B-cell lymphoma; prognosis