Neutrophil to lymphocyte ratio improves prognostic prediction of International Prognostic Index for patients with diffuse large B-cell lymphoma treated with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone

Abstract

The purpose of this study was to analyze the pre- and post-treatment neutrophil to lymphocyte ratio (pre- and post-NLR) in combination with immunologic profiles in patients with diffuse large B-cell lymphoma (DLBCL) treated with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP). A total of 447 newly diagnosed patients with DLBCL treated with R-CHOP were analyzed retrospectively. A pre-NLR ≥ 3 was independently associated with poor progression-free survival (PFS) (hazard ratio [HR] = 2.19, p < 0.001) and overall survival (OS) (HR = 2.89, p < 0.001). In patients with high pre-NLR, reduction of the post-NLR to < 3 after R-CHOP was correlated with improved survival. Low pre-NLR (< 3) was also associated with a higher number of peripheral CD19 + lymphocytes (p = 0.049) and NK cells (p = 0.031). In conclusion, a pre-NLR ≥ 3 was an independent prognostic factor for PFS and OS in patients with DLBCL treated with R-CHOP.

Keywords::

• Neutrophil to lymphocyte ratio
• diffuse large B-cell lymphoma
• prognosis

Acknowledgement

This study was supported by grants from the Innovative Research Institute for Cell Therapy, Republic of Korea (A062260).

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article at www.informahealthcare.com/lal.

Supplementary material available online

Figures 1–2 and Table I showing further data.