Abstract:
OBJECTIVES:The clinical course and prognosis of follicular lymphoma (FL) are diverse and associated with the patient's immune response. We investigated the lymphocyte-to-monocyte ratio (LMR) and neutrophil-to-lymphocyte ratio (NLR) as prognostic factors in patients with FL, including those receiving radiotherapy. DESIGN:A retrospective cohort study. SETTING:Regional cancer centre in Hong Kong. PARTICIPANTS:88 patients with histologically proven FL diagnosed between 2000 and 2014. MATERIALS AND METHODS:The best LMR and NLR cut-off values were determined using cross-validated areas under the receiver operating characteristic curves. The extent to which progression-free survival (PFS) and overall survival differed by NLR and LMR cut-off values was assessed using Kaplan-Meier analysis and log-rank tests. A Cox proportional hazards model was fitted to adjust for confounders. RESULTS:The best cut-off values for LMR and NLR were 3.20 and 2.18, respectively. The 5-year PFS was 73.6%. After multivariate adjustment, high LMR (>3.20) at diagnosis was associated with superior PFS, with a HR of 0.31 (95% CI 0.13 to 0.71), whereas high NLR at relapse was associated with poorer postprogression survival (HR 1.24, 95% CI 1.04 to 1.49). CONCLUSIONS:Baseline LMR and NLR at relapse were shown to be independent prognostic factors in FL. LMR and NLR are cheap and widely available biomarkers that could be used in combination with the Follicular Lymphoma International Prognostic Index by clinicians to better predict prognosis.
journal_name
BMJ Openjournal_title
BMJ openauthors
Lee SF,Luque-Fernandez MAdoi
10.1136/bmjopen-2017-017904subject
Has Abstractpub_date
2017-11-03 00:00:00pages
e017904issue
11issn
2044-6055pii
bmjopen-2017-017904journal_volume
7pub_type
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