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 Dec;60(14):3386-3394. doi: 10.1080/10428194.2019.1633628. Epub 2019 Jul 1.

Abstract

In solid tumors and lymphomas, the neutrophil/lymphocyte (N/L) ratio at diagnosis has been shown to be a prognostic factor. The aim of our study was to validate the originally reported N/L ratio cut-point of 3.5 in patients with diffuse large B-cell lymphoma (DLBCL) registered in an Italian real-life database. The prognostic role of the N/L ratio at diagnosis on event-free survival (EFS) and overall survival (OS) was assessed in 505 patients with DLBCL. Patients with an N/L ratio <3.5 (n = 249) had a 4-year EFS probability of 76% and OS probability of 86%, significantly higher than the 4 year EFS rate of 48% and OS rate of 64% in patients with N/L ratio ≥3.5 (n = 256, both p<.0001). The N/L ratio was an independent prognostic factor in the multivariate analysis including the IPI score, and could separate patients with a low/intermediate risk IPI (IPI <3).

Keywords: DLBCL; N/L ratio; R-CHOP; cancer; lymphoma.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Biomarkers, Tumor / analysis*
  • Cyclophosphamide / administration & dosage
  • Databases, Factual
  • Doxorubicin / administration & dosage
  • Female
  • Follow-Up Studies
  • Humans
  • Italy
  • Lymphocytes / pathology*
  • Lymphoma, Large B-Cell, Diffuse / drug therapy
  • Lymphoma, Large B-Cell, Diffuse / mortality*
  • Lymphoma, Large B-Cell, Diffuse / pathology
  • Male
  • Middle Aged
  • Neutrophils / pathology*
  • Prednisone / administration & dosage
  • Prognosis
  • Retrospective Studies
  • Rituximab / administration & dosage
  • Survival Rate
  • Vincristine / administration & dosage
  • Young Adult

Substances

  • Biomarkers, Tumor
  • Rituximab
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone