TY - JOUR
T1 - A Multi-Institutional Validation of the Prognostic Value of the Neutrophil-to-Lymphocyte Ratio in Patients With Diffuse Large B-Cell Lymphoma
T2 - A Study From The Latin American Group of Lymphoproliferative Disorders (GELL)
AU - The Latin American Group of Lymphoproliferative Disorders (Grupo de Estudio Latinoamericano de Linfoproliferativos [GELL])
AU - Beltrán, Brady E.
AU - Villela, Luis
AU - Torres, Maria A.
AU - Otero, Victoria
AU - Fiad, Lorena
AU - Peña, Camila
AU - Cabrera, Maria E.
AU - León, Pilar
AU - Idrobo, Henry
AU - Castro, Denisse A.
AU - Paredes, Sally
AU - Perdomo, Ivan
AU - Abello, Virginia
AU - Rojas, Christine
AU - Ramirez-Ibargüen, Ana
AU - Candelaria, Myrna
AU - Pérez-Jacobo, Fernando
AU - Montaño-Figueroa, Efren
AU - Best, Carlos
AU - Goméz-De Leon, Andres
AU - Gómez-Almaguer, David
AU - Ruiz-Argüelles, Guillermo
AU - Hernández-Hernández, Jose
AU - Malpica, Luis
AU - Sotomayor, Eduardo M.
AU - Castillo, Jorge J.
N1 - Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/10
Y1 - 2020/10
N2 - Introduction: We aimed at investigating the prognostic role of the neutrophil-to-lymphocyte ratio (NLR) in 2 independent cohorts of Latin American patients with diffuse large B-cell lymphoma (DLBCL) treated with chemoimmunotherapy. Patients and Methods: The learning cohort was composed of 274 patients and the validation cohort of 323 patients, for a total of 597 patients. An optimal NLR cutoff ≥ 4 was determined using receiver operating characteristic analysis. Results: In multivariate models, NLR ≥ 4 was independently associated with lower odds for complete response to chemoimmunotherapy in the learning (odds ratio, 0.46; P =.006) and the validation cohort (odds ratio, 0.49; P =.01), and independently associated with worse survival in the learning (hazard ratio, 1.55; P =.04) and the validation cohort (hazard ratio, 1.80; P =.003). Conclusions: The adverse prognostic value of NLR ≥ 4 was independent of the International Prognostic Index and the National Comprehensive Cancer Network-International Prognostic Index score. Based on the results of this multi-institutional study, NLR ≥ 4 emerges as an adverse prognostic factor in Latin American patients with DLBCL treated with chemoimmunotherapy.
AB - Introduction: We aimed at investigating the prognostic role of the neutrophil-to-lymphocyte ratio (NLR) in 2 independent cohorts of Latin American patients with diffuse large B-cell lymphoma (DLBCL) treated with chemoimmunotherapy. Patients and Methods: The learning cohort was composed of 274 patients and the validation cohort of 323 patients, for a total of 597 patients. An optimal NLR cutoff ≥ 4 was determined using receiver operating characteristic analysis. Results: In multivariate models, NLR ≥ 4 was independently associated with lower odds for complete response to chemoimmunotherapy in the learning (odds ratio, 0.46; P =.006) and the validation cohort (odds ratio, 0.49; P =.01), and independently associated with worse survival in the learning (hazard ratio, 1.55; P =.04) and the validation cohort (hazard ratio, 1.80; P =.003). Conclusions: The adverse prognostic value of NLR ≥ 4 was independent of the International Prognostic Index and the National Comprehensive Cancer Network-International Prognostic Index score. Based on the results of this multi-institutional study, NLR ≥ 4 emerges as an adverse prognostic factor in Latin American patients with DLBCL treated with chemoimmunotherapy.
KW - Biomarkers
KW - DLBCL
KW - NLR
KW - Overall survival
KW - Prognostic factor
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U2 - 10.1016/j.clml.2020.04.016
DO - 10.1016/j.clml.2020.04.016
M3 - Article
C2 - 32513598
AN - SCOPUS:85085950627
SN - 2152-2650
VL - 20
SP - 637
EP - 646
JO - Clinical Lymphoma, Myeloma and Leukemia
JF - Clinical Lymphoma, Myeloma and Leukemia
IS - 10
ER -