The neutrophil-to-lymphocyte ratio (NLR) has been known to predict the prognosis in diffuse large B-cell lymphoma (DLBCL). We planned to design a new prognostic model in DLBCL using well-known prognostic index and NLR.
The data of 232 DLBCL patients treated with first-line R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone) from 2004 to 2017 were retrospectively reviewed. Patients with NLR ≥6 and <6 were determined as the high and low NLR groups, respectively. Treatment response and survival were compared according to NLR status. Nomograms for predicting 5-year progression-free survival (PFS) and overall survival (OS) rates were constructed using NLR and other prognostic factors based on the National Comprehensive Cancer Network-International Prognostic Index (NCCN-IPI) NCCN-IPI.
The high NLR group had a low complete response (CR) rate compared to low NLR group (51.6% vs. 83.5%; p<0.001). The 5-year PFS and OS rates were 27.4% and 30% in the high NLR group and 61.1% and 63.7% in the low NLR group, respectively (both p<0.001). Multivariate analyses confirmed that NLR is one of the independent risk factors for failure to achieve CR and for worse PFS and OS. The nomogram showed superior discrimination ability for predicting 5-year PFS and OS rates compared with NCCN-IPI (c index 0.78 vs. 0.75 and 0.79 vs. 0.75, respectively).
High NLR was associated with poor treatment response and worse PFS and OS in DLBCL. The nomogram developed from NCCN-IPI-based variables and NLR may help the clinicians to predict the prognosis individually in DLBCL patients, although it needs to be validated in the independent cohort.
Post author correction
Article Type: ORIGINAL RESEARCH ARTICLE
Article Subject: Hemato-Oncology
AuthorsSe-Il Go, Sungwoo Park, Jung Hoon Kim, Hye Ree Kim, Minyoung Kim, Kyunglan Moon, Jangho Seo, Gyeong-Won Lee
- • Accepted on 27/10/2017
- • Available online on 16/12/2017
This article is available as full text PDF.
- Go, Se-Il [PubMed] [Google Scholar] 1
- Park, Sungwoo [PubMed] [Google Scholar] 2
- Kim, Jung Hoon [PubMed] [Google Scholar] 2
- Kim, Hye Ree [PubMed] [Google Scholar] 2
- Kim, Minyoung [PubMed] [Google Scholar] 2
- Moon, Kyunglan [PubMed] [Google Scholar] 2
- Seo, Jangho [PubMed] [Google Scholar] 2
- Lee, Gyeong-Won [PubMed] [Google Scholar] 2, 3, * Corresponding Author (firstname.lastname@example.org)
Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon - Republic of Korea
Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju - Republic of Korea
Institute of Health Science, Gyeongsang National University School of Medicine, Jinju - Republic of Korea