Özcan ÇENELİ, Atakan TEKİNALP, Sinan DEMİRCİOĞLU, Ahmet Faruk ÇELİK

The effect of neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR) and mean platelet volume to thrombocyte ratio (MPV/PLT) on survival in myelodysplastyc syndrome

Aim: The aim of the study is to evaluate the relationship between age and leukocyte subtype ratio and their effects on survival in patients diagnosed with myelodysplastic syndrome (MDS). Materials and Methods: We retrospectively examined total of 101 patients diagnosed with MDS between January 2010 and June 2020. The patients were analysed by dividing into two groups; < 70 years and ≥70 years. Results: The median of overall survival was significantly higher in < 70 years’ group (96 vs 40 month, OR 3.6; 95% CI, 1.6-8.7, p < 0.001). Whereas neutrophil-to-lymphocyte ratio (NLR) was significantly higher in ≥70 years group, lymphocyte-to-monocyte ratio (LMR) was significantly higher in < 70 years group (p = 0,013 and p = 0,041, respectively). NLR was positively correlated with age (rho: 0.27, p = 0.007) but negatively correlated with clinical risk (rho: -0.24, p = 0.018), MPV/PLT ratio was positively correlated with IPSS group (rho: 0.40, p < 0.001). In multivariate analysis, its found that age and IPSS group effects overall survival. HR was 1.064 (95% CI; 1.033-1.096, p < 0.001) for age and was 3.664 (95% CI; 1.285-10.445, p < 0.015) for IPSS group (low versus intermediate-2). Conclusion: We concluded that NLR and LMR may have a prognostic value for patients who are ≥70 years diagnosed MDS.

PDF

___

1. Steensma DP, Bejar R, Jaiswal S, Lindsley RC, Sekeres MA, Hasserjian RP et al. Clonal hematopoiesis of indeterminate potential and its distinction from myelodysplastic syndromes. Blood. 2015; 126: 9–16.
2. Abel GA, Efficace F, Buckstein RJ, Tinsley S, Jurcic JG, Martins Y et al. Prospective international validation of the quality of life in myelodysplasia scale (QUALMS). Haematologica. 2016; 101(6): 781-8.
3. Goldberg SL, Chen E, Corral M, Guo A, Mody-Patel N, Pecora AL et al. Incidence and clinical complications of myelodysplastic syndromes among United States Medicare beneficiaries. J Clin Oncol. 2010;28(17):2847–52.
4. Kuendgen A, Strupp C, Aivado M, Hildebrandt B, Haas R, Gattermann N et al. Myelodysplastic syndromes in patients younger than age 50. J Clin Oncol. 2006;24(34):5358–65.
5. Della Porta MG, Tuechler H, Malcovati L, Schanz J, Sanz G, Garcia-Manero G et al. Validation of WHO classificationbased Prognostic Scoring System (WPSS) for myelodysplastic syndromes and comparison with the revised International Prognostic Scoring System (IPSS-R). A study of the International Working Group for Prognosis in Myelodyspla. Leukemia. 2015;29(7):1502–13.
6. Xia LJ, Li W, Zhai JC, Yan CW, Chen JB, Yang H. Significance of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio and prognostic nutritional index for predicting clinical outcomes in T1-2 rectal cancer. BMC Cancer. 2020;20(1):208.
7. Williamson PJ, Kruger AR, Reynolds PI, Hamblin TJ, Oscier DG. Establishing the incidence of myelodysplastic syndrome. Br J Haematol. 1994;87(4):743–5.
8. Chihara D, Ito H, Katanoda K, Shibata A, Matsuda T, Sobue T et al. Incidence of myelodysplastic syndrome in Japan. J Epidemiol. 2014;24(6):469–73.
9. Wang H, Wang X, Xu X, Lin G. Cytogenetic features and prognosis analysis in Chinese patients with myelodysplastic syndrome: A multicenter study. Ann Hematol. 2010;89(6):535–44.
10. Garcia-Manero G, Shan J, Faderl S, Cortes J, Ravandi F, Borthakur G et al. A prognostic score for patients with lower risk myelodysplastic syndrome. Leukemia. 2008;22(3):538–43.
11. Pileggi C, Sanzo M Di, Mascaro V, Marafioti MG, Costanzo FS, Pavia M. Role of serum ferritin level on overall survival in patients with myelodysplastic syndromes: Results of a meta-analysis of observational studies. PLoS One. 2017;12(6); e0179016.
12. Kikuchi S, Kobune M, Iyama S, Sato T, Murase K, Kawano Y et al. Prognostic significance of serum ferritin level at diagnosis in myelodysplastic syndrome. Int J Hematol. 2012;95(5):527–34.
13. Nösslinger T, Tüchler H, Germing U, Sperr WR, Krieger O, Haase D et al. Prognostic impact of age and gender in 897 untreated patients with primary myelodysplastic syndromes. Ann Oncol. 2009;21(1):120–5.
14. 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.
15. Isaac V, Wu CY, Huang CT, Baune BT, Tseng CL, McLachlan CS. Elevated neutrophil to lymphocyte ratio predicts mortality in medical inpatients with multiple chroni cconditions. Medicine (Baltimore) 2016;95(23): e3832.
16. Wang J, Gao K, Lei W, Dong L, Xuan Q, Feng M et al. Lymphocyte-to-monocyte ratio is associated with prognosis of diffuse large B-cell lymphoma: Correlation with CD163 positive M2 type tumor-associated macrophages, not PD-1 positive tumor-infiltrating lymphocytes. Oncotarget. 2017;8(3):5414–25.
17. Stefaniuk P, Szymczyk A, Podhorecka M. The neutrophil to lymphocyte and lymphocyte to monocyte ratios as new prognostic factors in hematological malignancies – a narrative review. C. 12, Cancer Management and Research. 2020. s. 2961–77.
18. Doğan A and Demircioğlu S. Assessment of the neutrophillymphocyte ratio in classic Hodgkin lymphoma patients. Pakistan journal of medical sciences. 2019;35(5):1270-5.
19. Lee SF, Ng TY, Spika D. Prognostic value of lymphocytemonocyte ratio at diagnosis in Hodgkin lymphoma: A metaanalysis. BMC Cancer. 2019;19(1):338.
20. Cox MC, Nofroni I, Ruco L, Amodeo R, Ferrari A, La Verde G et al. Low absolute lymphocyte count is a poor prognostic factor in diffuse-large-B-cell-lymphoma. Leuk Lymphoma. 2008;49(9):1745–51.
21. Mushtaq MU, Chaudhary SG, Guru Murthy GS, Hall AC, Atallah EL, Mattison RJ. Prognostic Significance of Neutrophilto-Lymphocyte Ratio in Relapsed/Refractory Acute Myeloid Leukemia. Blood [Internet]. 29 Kasım 2018;132(Supplement 1):5246. Available at: https://doi.org/10.1182/blood-2018-99- 112204
22. Lucijanic M, Cicic D, Stoos-Veic T, Pejsa V, Lucijanic J, Dzankic AF et al. Elevated neutrophil–to–Lymphocyte-ratio and platelet–to–Lymphocyte ratio in myelofibrosis: Inflammatory biomarkers or representatives of myeloproliferation itself? Anticancer Res. 2018;38(5):3157–63.
23. Aksoy S, Kılıçkap S, Hayran M, Harputoğlu H, Koca E DD et al. Platelet size has diagnostic predictive value for bone marrow metastasis in patients with solid tumors. Int J Lab Hematol. 2008;30(3):214–9.
24. Inagaki N, Kibata K, Tamaki T, Shimizu T, Nomura S. Prognostic impact of the mean platelet volume/platelet count ratio in terms of survival in advanced non-small cell lung cancer. Lung cancer. 2014;83(1):97–101.