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Prognostic significance of peripheral blood absolute lymphocyte count and derived neutrophil to lymphocyte ratio in patients with newly diagnosed extranodal natural killer/T-cell lymphoma

Authors Zhou X, Sun X, Zhao W, Fang X, Wang X

Received 4 November 2018

Accepted for publication 14 February 2019

Published 7 May 2019 Volume 2019:11 Pages 4243—4254

DOI https://doi.org/10.2147/CMAR.S193397

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Professor Lu-Zhe Sun


Xiangxiang Zhou,1,* Xiaogang Sun,1,* Wenbo Zhao,1 Xiaosheng Fang,1 Xin Wang1,2

1Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, People’s Republic of China; 2Department of Diagnostics, School of Medicine, Shandong University, Jinan, People’s Republic of China
 
*These authors contributed equally to this work

Background:
Accumulating evidence suggested that tumor microenvironment and host immune system played important roles in determining the clinical course and outcome of human malignancies. The derived neutrophil to lymphocyte ratio (dNLR) and absolute lymphocyte count (ALC) were demonstrated to act as a prognostic factor in several malignancies. Nevertheless, the prognostic significance of them in extranodal natural killer/T-cell lymphoma (ENKTL) patients has never been explored.
Patients and methods: A total of 33 newly diagnosed patients with ENKTL were included in this study. Clinicopathological characteristics were collected and prognostic significance of dNLR and ALC were evaluated.
Results: Elevated dNLR and low ALC were both associated with poor survival rates. Patients with dNLR ≥3.6 revealed significantly shorter overall survival (OS) (P=0.001) and progression-free survival (PFS) (P=0.008) than those with dNLR 9,/L had worse OS (P=0.008) and PFS (P<0.001) than those with ALC ≥0.8×109,/L. An independent significant association between low ALC and poor clinical outcome in multivariate analysis for OS (HR, 36.023; 95% CI, 2.438–532.243; P=0.009) as well as PFS (HR, 7.698; 95%CI, 1.573–37.679; P=0.012) was identified.
Conclusion: In this study, we validated for the first time the prognostic value of dNLR and ALC in ENKTL patients. Elevated dNLR and low ALC were both associated with aggressive tumor process and poor survival.ALC value at diagnosis represented an independent favorable prognostic factor for the clinical outcome of ENKTL patients.

Keywords: derived neutrophil to lymphocyte ratio, absolute lymphocyte count, extranodal NK/T-cell lymphoma, prognosis, progression-free survival, overall survival

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