scholarly journals The Neutrophil-to-Lymphocyte Ratio Is Prognostic in Patients with Early Stage Peripheral T-Cell Lymphoma

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5346-5346
Author(s):  
Brady E Beltran ◽  
Denise Castro ◽  
Rodrigo Motta ◽  
Sally Paredes ◽  
Jose M Malaga ◽  
...  
Keyword(s):  
T Cell ◽  
Prognostic Factor ◽  
Research Funding ◽  
Cell Lymphoma ◽  
Early Stage ◽  
Prognostic Index ◽  
T Cell Lymphoma ◽  
Neutrophil To Lymphocyte Ratio ◽  
Peripheral T Cell Lymphoma ◽  
Lymphocyte Ratio

Abstract Introduction: Peripheral T-cell lymphoma (PTCL) encompasses a group of rare and aggressive lymphomas. PTCL, unspecified (PTCLU) is the most common subtype of PTCL, and carries a poor prognosis. The International Prognostic Index (IPI) and the Prognostic Index for PTCLU (PIT) scoring systems are powerful risk-stratification tools in patients with PTCL. The neutrophil-to-lymphocyte ratio (NLR) has shown to be prognostic in patients with advanced stage PTCLU (Beltran Leuk Lymphoma 2016). The aim of this study was to evaluate whether the NLR is a prognostic factor in patients with early stage PTCLU. Methods: We included patients with a pathological diagnosis of PTCLU who were diagnosed and treated at our institution between 2001-2016. We excluded cases with stage 3 or 4 disease. IRB approval was obtained prior to research. Pathological samples were reviewed by hematopathologists to confirm the diagnosis. Pertinent clinicopathological data were collected through chart review, and are presented using descriptive statistics. The NLR was calculated by dividing the neutrophil by the lymphocyte count, and dichotomized in NLR>=4 and NLR<4. Survival curves were estimated using the Kaplan-Meier method and compared using the log-rank test. Univariate Cox models were fitted to evaluate hazard ratios (HR) for overall survival (OS). Results: 48 patients with a diagnosis of early stage PTCL were included in this analysis. Histologically, 40 patients (83%) were PTCL, unspecified, 7 (15%) were anaplastic large cell lymphoma, and 1 (2%) was enteropathy-associated T-cell lymphoma. The median age at diagnosis was 60 years (range 18-83 years) with a slight male predominance (82%). Clinically, 49% of patients were 60 or older, 34% presented with ECOG>1, 36% with elevated LDH, and 65% with extranodal disease; 44% had stage II and 56% had stage I disease. No patient had bone marrow involvement. 30% of patients presented with high/high-intermediate IPI score and 34% with high/high-intermediate PIT score. 27% of patients had a NLR >=4. There were no differences in age, LDH levels, extranodal involvement and stage between NLR>=4 and NLR<4. There was a trend towards worse ECOG performance status in NLR>=4 patients (p=0.06). The 3- and 5-year OS rates were 67% (95% CI 50-80%) and 52% (95% CI 29-71%), respectively. High/high-intermediate IPI score was associated with a worse outcome (HR 4.9, 95% CI 1.7-14.2; p=0.004), as well as high-high-intermediate PIT score (HR 3.9, 95% CI 1.2-12.7; p=0.03). According to NLR, NLR>=4 patients had a higher risk of death (HR 9.9, 95% CO 3.2-30.1; p<0.001). In a multivariate analysis adjusting for IPI and PIT scores, NLR>=4 was the only independent factor associated with a worse survival (HR 6.2, 95% CI 1.9-20.9; p=0.003). Conclusion: The NLR appears as a novel and easy to use prognostic factor for OS in previously untreated patients with early-stage PTCL. Our findings support the need for validation of the NLR in larger retrospective or prospective studies in patients with PTCL. Disclosures Castillo: Otsuka: Consultancy; Pharmacyclics: Honoraria; Abbvie: Research Funding; Millennium: Research Funding; Janssen: Honoraria; Biogen: Consultancy.

The neutrophil-to-lymphocyte ratio is an independent prognostic factor in patients with peripheral T-cell lymphoma, unspecified

2015 ◽  
Vol 57 (1) ◽  
pp. 58-62 ◽  
Author(s):  
Brady E. Beltran ◽  
Christian Aguilar ◽  
Pilar Quiñones ◽  
Domingo Morales ◽  
Julio C. Chavez ◽  
...  
Keyword(s):  
T Cell ◽  
Prognostic Factor ◽  
Cell Lymphoma ◽  
Independent Prognostic Factor ◽  
T Cell Lymphoma ◽  
Neutrophil To Lymphocyte Ratio ◽  
Peripheral T Cell Lymphoma ◽  
Lymphocyte Ratio

Low Absolute Lymphocyte Count Predicts Chemotherapy Response and Survival In Peripheral T-Cell Lymphoma, NOS

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 3135-3135
Author(s):  
Yu Ri Kim ◽  
yun Deok Kim ◽  
Jin Seok Kim ◽  
June-Won Cheong ◽  
soo Jeong Kim ◽  
...  
Keyword(s):  
T Cell ◽  
Prognostic Factor ◽  
Overall Response Rate ◽  
Response Rate ◽  
Cell Lymphoma ◽  
Prognostic Index ◽  
Independent Prognostic Factor ◽  
T Cell Lymphoma ◽  
Peripheral T Cell Lymphoma ◽  
Overall Response

Abstract Abstract 3135 Peripheral T cell lymphoma, not otherwise specified (PTCL, NOS) is heterogenous groups of aggressive T-cell lymphoma and treatment outcome is dismal. Lymphopenia is an independent prognostic factor for survival for B-cell lymphoma. The ALC at diagnosis on survival in T-cell lymphoma has not been studied. Thus, we studied the role of ALC at diagnosis on clinical outcome in patients with PTCL, NOS. Between 2001 and 2009, 32 patients with PTCL, NOS reviewed for the study. Median patient age was 57 (range 34–78) years. Median ALC at the time of diagnosis was 1.54 (range 0.41–12.64×109/L). Patients were divided two groups according to ALC count 1.0 ×109/L. Ten patients (31%) had lower ALC at diagnosis. Median follow up duration was 299 days (range 11–2164 days). Overall response rate was 61.5% (16 of 26 patients) and complete response (CR) rate was 42% (11 of 26 patients). Only two patients reached CR in low ALC group.There was no significant difference in overall response rate because of small number of patients. Superior overall survival was observed with an ALC 1.0 × 109/L (N = 22) versus an ALC < 1.0 × 109/L (N=10) (median OS: not reached vs 242 days, OS rates at 5 years, 57% vs 0%, p =0.016, respectively). Multivariate analysis demonstrated ALC to be an independent prognostic indicator for OS (Hazard Ratio 3.5, 95% confidence intervals 1.2–10.2; p<0.019) when compared to the International prognostic index (IPI) and Prognostic Index for PTCLU (PIT). This study suggested that low ALC is an independent prognostic factor for survival in patients with PTCL, NOS. Disclosures: No relevant conflicts of interest to declare.

scholarly journals The neutrophil‐lymphocyte ratio is prognostic in patients with early stage aggressive peripheral T cell lymphoma

2018 ◽  
Vol 184 (4) ◽  
pp. 650-653 ◽  
Author(s):  
Brady E. Beltran ◽  
Denisse Castro ◽  
Jhony A. Cruz‐Vargas ◽  
Esther Cotrina ◽  
Aly Gallo ◽  
...  
Keyword(s):  
T Cell ◽  
Cell Lymphoma ◽  
Early Stage ◽  
T Cell Lymphoma ◽  
Peripheral T Cell Lymphoma ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

Fasting Blood Glucose As Prognostic Factor In Peripheral T-Cell Lymphoma: A Study Of 250 Cases

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 5080-5080
Author(s):  
Brady E Beltran ◽  
Jorge J Castillo
Keyword(s):  
Blood Glucose ◽  
T Cell ◽  
Prognostic Factor ◽  
Who Classification ◽  
Cell Lymphoma ◽  
Fasting Blood Glucose ◽  
Prognostic Index ◽  
T Cell Lymphoma ◽  
Peripheral T Cell Lymphoma ◽  
Anaplastic Lymphoma

Abstract Background Peripheral T-cell lymphoma (PTCL) is a heterogeneous familyof entities with a worse prognosis, stage by stage, than theirB-cell counterparts. Fasting blood glucose (FBG) level at diagnosis has recently been described as a novel, independent prognostic factor for survival in patients with extranodal natural killer/T-cell lymphoma (NKTCL). The goal of this study is to retrospectively investigatethe prognostic value of FBG at lymphoma diagnosis in the survival of patientswith PTCL. Methods A total of 250 cases of aggressive, non-primary cutaneous PTCLdiagnosed at our institution between January 1997 and December 2012 were reviewed,reevaluated according to their morphological, immunologicaland clinical characteristics, and reclassified according tothe 2008 WHO classification of lymphoid neoplasms. Characteristics are presented descriptively. For the evaluation of FBG, patients were divided in 2 categories; those patients with an FBG at diagnosis >100 mg/dl (hyperglycemia) and those with an FBG at diagnosis <100 mg/dl (normoglycemia). Overall survival (OS) was defined as the time elapsed between lymphoma diagnosis and death or last follow-up. The Kaplan-Meiermethod was used to estimate OS curves, which were then comparedusing the log-rank test. P-values less than 0.05 were considered statistically significant. Results According to the new WHO classification, 104 cases (41%) were classified as adult T-cell leukemia/lymphoma (ATLL), 103 cases (41%) as PTCL, unspecified (PTCLU), 26 cases (11%) as anaplastic lymphoma kinase (ALK)-negative anaplastic large cell lymphoma (ALCL), 10 cases (4%) as extranodal NKTCL, nasal type, 4 cases (2%) as angioimmunoblastic lymphoma (AIL), 2 cases (1%) as ALK-positive ALCL, and 1 case (0.4%) as hepatosplenic T-cell lymphoma. The median age at diagnosis was 57 years (range 14-92 years); 47% of patients were >60 years. The male-to-female ratio was 1:1. ECOG performance status >1 was seen in 51%, LDH was elevated in 67%, advanced stage was seen in 73%, and >1 extranodal sites were seen in 22% of the patients. Bone marrow involvement was reported in 30% and B symptoms in 64% of patients. FBG >100 mg/dl was seen in 34% and FBG <100 mg/dl in 66%. An International Prognostic Index (IPI) score 3-5 was seen in 52%, and a Prognostic Index for PTCLU (PIT) score of 2-4 in 62%.  Response evaluation was performed only in patients who received chemotherapy (n=161). The overall response rate (ORR) was 47% (n=76) with complete response (CR) in 32% (n=52) and partial response (PR) in 15% (n=24). FBG was no associated with ORR or CR (p=0.25 and p=0.43, respectively. We then evaluated FBG separately in patients with ATLL and PTCL except ATLL. In ATLL patients, the median OS was 8 months with a 3-year OS of 33%. In PTCL patients, the median OS was 17 months with a 3-year OS of 49%. FBG >100 appeared as an adverse prognostic factor only in PTCL patients with a median OS that was not reached vs. 27 months in patients with FBG <100 mg/dl (Figure; log-rank p=0.035). No difference was seen in patients with ATLL; patients with FBG >100 mg/dl has a median OS of 16 months vs. 18 months in patients with FBG <100 mg/dl (log-rank p=0.95). Conclusions Based on the results of our single-center retrospective study, FBG >100 mg/dl appears as a prognostic factor in PTCL but not in patients with ATLL. Additional studies are needed to investigate the role of hyperglycemia in patients with PTCL, and to evaluate if controlling hyperglycemia during therapy could improve the survival on such patients. Disclosures: No relevant conflicts of interest to declare.

Prognostic Value of Platelet Count in Patients with Peripheral T Cell Lymphoma

2019 ◽  
Vol 141 (3) ◽  
pp. 176-186 ◽  
Author(s):  
Mihong Choi ◽  
Jeong-Ok Lee ◽  
Jongheon Jung ◽  
Ji Yun Lee ◽  
Eunyoung Lee ◽  
...  
Keyword(s):  
Platelet Count ◽  
T Cell ◽  
Prognostic Factor ◽  
Cox Regression ◽  
Cell Lymphoma ◽  
Prognostic Index ◽  
Progression Free Survival ◽  
T Cell Lymphoma ◽  
Peripheral T Cell Lymphoma ◽  
Poor Prognostic Factor

Background: Peripheral T cell lymphoma (PTCL) is a heterogeneous entity with poor survival. We evaluated the neutrophil-to-lymphocyte ratio (NLR), absolute lymphocyte count (ALC), and platelet count as new prognostic factors for PTCL. Patients and Methods: We retrospectively analyzed 77 patients with PTCL initially treated with anthracycline-based chemotherapy. Survival curves were compared between groups with different initial NLR (iNLR), end-point NLR (eNLR), initial ALC, and platelet counts. Cox regression was used to analyze the risk factor for survival. Results: Patients with a higher eNLR (≥3), lymphopenia (< 1,000/μL), and thrombocytopenia (< 150 K/μL) had an inferior progression-free survival (PFS) and overall survival (OS) compared to their counterparts, while a higher iNLR (≥3) was predictive of a shorter OS but not PFS. Among these, thrombocytopenia was an independent poor prognostic factor for both PFS and OS, with a hazard ratio of 2.42 (p = 0.012) for PFS and 4.21 (p = 0.006) for OS. The presence of thrombocytopenia further stratified patients with a worse prognosis within overlapping risk-groups by the prognostic index for PTCL. Conclusions: Our study showed that thrombocytopenia at diagnosis was an independent prognostic factor for survival in patients with PTCL.

scholarly journals Prognostic significance of the neutrophil-to-lymphocyte ratio in peripheral T-cell lymphoma: a meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jia Liu ◽  
Shengnan Zhang ◽  
Ruihua Mi ◽  
Lin Chen ◽  
Qingsong Yin
Keyword(s):  
T Cell ◽  
Cell Lymphoma ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
T Cell Lymphoma ◽  
Neutrophil To Lymphocyte Ratio ◽  
Cochrane Library ◽  
Prognostic Impact ◽  
Peripheral T Cell Lymphoma ◽  
Lymphocyte Ratio

AbstractThe neutrophil-to-lymphocyte ratio (NLR) as an inflammatory marker may represent changes between inflammation and host immunity that affect the prognosis of peripheral T-cell lymphoma (PTCL). To comprehensively evaluate the NLR in PTCL, we performed a meta-analysis to investigate the relationship between the NLR and overall survival (OS) and progression-free survival (PFS). PubMed, Embase, Cochrane library, and China National Knowledge Infrastructure (CNKI) were searched for all relevant studies. Hazard ratios (HRs) and 95% confidence intervals (CIs) were obtained from each study. Heterogeneity among the included studies was checked to determine whether fixed or random effects model was used. In total, 8 studies with 921 patients were included for the meta-analysis. High NLR significantly correlated with worse OS (HR = 2.20, 95% CI 1.71–2.83, P < 0.05) regardless of region (Asian or non-Asian), sample size (< 60 or ≥ 60), median age (< 60 or ≥ 60), disease type, or cut-off value (NLR < 3.9 or NLR ≥ 3.9). In terms of PFS, the NLR had no prognostic impact for patients with PTCL (HR = 1.12, 95% CI 0.57–2.20, P = 0.742). Our findings suggest that PTCL patients with high NLR are more likely to have worse OS compared to those with low NLR. Therefore, the NLR can serve as a prognostic marker in PTCL.

scholarly journals Impact of Comorbidities on Outcomes of Peripheral T Cell Lymphoma in Elderly Patients: An International Retrospective Study

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 27-28
Author(s):  
Monica Mead ◽  
Henrik Cederleuf ◽  
Thomas Relander ◽  
Mats Jerkeman ◽  
Fredrik Ellin ◽  
...  
Keyword(s):  
T Cell ◽  
Elderly Patients ◽  
Cause Of Death ◽  
Research Funding ◽  
Cell Lymphoma ◽  
T Cell Lymphoma ◽  
Rank Test ◽  
Peripheral T Cell Lymphoma ◽  
Cutaneous Lymphomas ◽  
Ann Arbor

Background: Peripheral T cell lymphoma (PTCL) is a heterogeneous group of aggressive lymphoid neoplasms with poor outcomes. Many patients are elderly with increased comorbidities. Single-center retrospective studies describe outcomes in elderly PTCL patients and suggest comorbidity adversely affects outcomes. Little is known about the treatment, outcomes and impact of comorbidity in a large cohort of elderly PTCL patients. This study aims to describe outcomes of elderly PTCL patients in a large unselected international patient cohort. Methods: Patients with PTCL age ≥ 70 diagnosed from January 1, 2010 - December 31, 2015 in the Swedish Lymphoma Registry (SLR) and California Cancer Registry (CCR) were identified. The SLR covers ~ 95% of adult lymphoma patients in Sweden and the CCR includes information on all cancers diagnosed in California. Patients with precursor T-cell malignancies, primary cutaneous lymphomas, and leukemic subtypes were excluded. Data on comorbidity at diagnosis were retrospectively collected according to the Charlson Comorbidity Index (CCI) and clinical outcomes of the cohort were extracted. Statistical analysis: Patient characteristics, clinical variables and outcomes were summarized using descriptive statistics and compared by Chi-square or Fisher's exact test. Outcomes of interest included overall survival (OS) and cause of death. Kaplan-Meier estimates of OS stratified by groups were calculated and presented in figures. Median OS was reported with 95% confidence interval (CI). Comparisons between groups for OS were done by log-rank test. Univariate and multiple Cox proportional hazards models provided hazards ratio estimates and 95% CI for risk factors. Tests for significance were two-tailed and a p-value less than the 0.05 significance level was considered statistically significant. Analyses were performed using software SAS version 9.4 (2013). Results: A total of 839 patients were included (SLR, n = 176, CCR, n = 663). Median age was 78 (SLR) and 79 (CCR) years, respectively. Included subtypes were AITL, n = 226; ALCL, n = 122; EATL, n = 31; Hepatosplenic TCL, n = 7; NK/T-cell lymphoma, n = 10; and PTCL NOS, n = 443. ECOG performance status was not available. CCI data was available in 731 patients (87 %), and CCI scores were divided into groups = 0-1 (61 %) and CCI &gt; 1 (39 %). Male patients more often had a CCI score &gt; 1 (p = 0.024). No other significant baseline differences were seen between the 2 groups (Table 1). Patients in the SLR more often received multiagent treatment compared to the CCR (63 % vs 44 %, p &lt; 0.001). Age &gt; 80 years, CCI &gt; 1 and advanced Ann Arbor stage (III-IV) were significant prognostic factors for worse outcome. No difference in survival was seen between men and women nor the SLR and CCR (Table 2). Patients with a CCI &gt;1 had a statistically significant worse survival compared to patients with a CCI =0-1 (0.36 years v 0.91 years, p=0.0001). Of the PTCL subtypes, AITL patients had a significantly better outcome (median OS = 1.26 years) compared to ALCL (OS = 0.57 years) and PTCL NOS (OS = 0.66 years). Patients receiving multiagent therapy had improved survival compared to patients not receiving multiagent therapy. When comparing OS in patients diagnosed in 2010-2012 with 2013-2015, no improvement was seen for the later period (Figures 1-4). Lymphoma was the most common cause of death with &gt; 70 % of deaths related to lymphoma irrespective of CCI score (Table 3). Discussion: At the time of submission, this study presents the largest international cohort of elderly patients with PTCL. Prognosis is poor and comorbidity seems to further worsen . In contrast to younger patient series, patients with AITL had a better survival than patients with PTCL NOS and ALCL, and were more common in the CCR than in the SLR. Multiagent treatment was associated with improved outcome. A possible confounder could be that fit patients are also the ones receiving treatment, and it is a setback that adjustment for ECOG was not possible, making treatment data somewhat difficult to interpret. As expected, advanced stage (Ann Arbor III-IV) was associated with worse survival. Conclusion: We believe this is one of the largest cohorts presented in elderly patients with PTCL. Comorbidity is an important adverse factor in this group, whereas treatment seems to improve outcome. The majority of these patients die of lymphoma within a year from diagnosis, and development of new treatments represents an unmet clinical need. Disclosures Jerkeman: Abbvie: Research Funding; Gilead: Research Funding; Celgene: Research Funding; Janssen: Research Funding; Roche: Research Funding.

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