Prognostic and Clinicopathological Significance of Platelet-to-Lymphocyte Ratio in Diffuse Large B-Cell Lymphoma: A Meta-Analysis

Abstract Background Recently, some studies reported the prognostic value of platelet-to-lymphocyte ratio (PLR) in patients with diffuse large B-cell lymphoma (DLBCL), however, the results varied from different studies. Therefore, we performed a meta-analysis to explore the prognostic value of PLR in DLBCL. Methods A comprehensive literature retrieval was conducted by using PubMed, Embase, Web of Science, the Cochrane Library, the China National Knowledge Infrastructure (CNKI), and Wanfang. Pooled hazard ratio (HR) and 95% confidence interval (CI) were used to evaluate the association of PLR and overall survival (OS) and progression-free survival (PFS). Odd ratios (ORs) and 95% CIs for clinicopathological characteristics were statistically analyzed. Results Eight studies with 1931 patients were included for meta-analysis. The pooled analysis indicated that elevated PLR was significantly associated with poor OS (HR = 1.73, 95% CI 1.29–2.31, p < 0.001), but not PFS (HR = 0.85, 95% CI 0.57–1.27, p = 0.438). Furthermore, elevated PLR was significantly associated with presentation of B symptoms (OR = 2.27, 95% CI 1.29–3.98, p = 0.004), elevated lactate dehydrogenase (LDH) (OR = 2.76, 95% CI 2.05–3.72, p < 0.001), higher tumor stage (OR = 2.22, 95% CI 1.66–2.98, p < 0.001), and Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≥ 2 (OR = 1.71, 95% CI 1.09–2.69, p = 0.019). However, elevated PLR was not significantly correlated with gender, age or cell of origin. Conclusion This meta-analysis revealed that PLR may be an effective and noninvasive biomarker for poor prognosis and aggressive disease characteristics for patients with DLBCL.

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Prognostic significance of neutrophil-to-lymphocyte ratio in diffuse large B-cell lymphoma: A meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0176008 ◽

2017 ◽

Vol 12 (4) ◽

pp. e0176008 ◽

Cited By ~ 10

Author(s):

Jin Wang ◽

Xu Zhou ◽

Yu Liu ◽

Zheng Li ◽

Xiang Li

Keyword(s):

B Cell ◽

Cell Lymphoma ◽

Meta Analysis ◽

Prognostic Significance ◽

B Cell Lymphoma ◽

Neutrophil To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Large B Cell Lymphoma ◽

Large B Cell

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Adverse Prognostic Impact of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Patients with Diffuse Large B Cell Lymphoma

Blood ◽

10.1182/blood.v124.21.5410.5410 ◽

2014 ◽

Vol 124 (21) ◽

pp. 5410-5410

Author(s):

Sun-Young Kong ◽

Hyewon Lee ◽

Ji Yeon Sohn ◽

Hyeon-Seok Eom

Keyword(s):

B Cell ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

Prognostic Impact ◽

Platelet To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Large B Cell Lymphoma ◽

The Mean ◽

The Impact ◽

Large B Cell

Abstract Neutrophil-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been lightened as a prognostic factor in many types of solid tumor. However, there was a limited report for diffuse large B cell lymphoma (DLBCL). Thus, we investigated the impact of NLR and PLR on prognosis of patients with DLBCL. This study involved 234 DLBCL patients treated by rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) at National Cancer Center, Korea. The median patient age was 57 years, and 135 patients (58%) were men. Clinical characteristics as international prognostic index (IPI) including age, performance, LDH, stage and extra-nodal involvement, were evaluated. NLR and PLR at diagnosis were calculated by CBC data from automated hematologic analyzer XE2100 (Sysmex, Kobe, Japan) or differential count which was done by manually using stained peripheral blood slide when CBC data showed flags in auto-analyzer. Hazard ratios (HRs) were determined in terms of risk for overall survival using Cox proportional hazard regression analysis. The mean percentage of neutrophils and lymphocytes was 60 (range, 5-95) and 12 (2-79), and the number of platelets was 257 × 10^9/L (28-839). The mean and standard deviation of NLR and PLR was 3.62 (±4.77) and 14.7 (±20.16), respectively. IPI and stage were predictors for prognosis (p <0.01), and both NLR and PLR showed significant association with poor prognosis of HRs of 1.14 [95% confidence interval (CI), 1.10 to 1.20] and 1.02 [95%CI, 1.02-1.03]. Although both NLR and PLR represented association with IPI, there were still prognostic impacts as HR of 1.12 and 1.02 with IPI in multivariate analysis. These findings suggest that NRL and PLR may be significant prognostic indicators for patients with DLBCL treated by R-CHOP. Disclosures No relevant conflicts of interest to declare.

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