COMPLETE BLOOD COUNT DERIVED INFLAMMATORY BIOMARKERS IN PATIENTS WITH HEMATOLOGIC MALIGNANCIES.
Nanava N,Betaneli M,Giorgobiani G,Chikovani T,Janikashvili N
Georgian medical news
Inflammation sometimes can be associated with the development of number of diseases, among them cancer. Few studies show prognostic value of different inflammatory markers, such as lymphocyte and monocyte count, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and others in some types of blood cancers. There is further need to investigate easy measurable diagnostic and prognostic novel biomarkers in hematologic malignancies. Our aim was to investigate the role of inflammatory markers: NLR, PLR, platelet-monocyte ratio (PMR), hemoglobin-platelet ratio (HPR), hemoglobin-lymphocyte ratio (HLR), lymphocyte-monocyte ratio (LMR), systemic immune-inflammation index (SII) and derived neutrophil-lymphocyte ratio (dNLR), which were used alone or in combination, in early diagnoses of hematologic malignancies. The counts for total white blood cells, neutrophils, lymphocytes, platelets, monocyte and hemoglobin as well as systemic inflammatory factors, such as NLR, PLR, PMR, HPR, HLR, LMR, SII and dNLRwere analysed from patients with hematologic malignancies and their age-matched controls. The area under the curve (AUC), sensitivity, specificity and cut-off values, as well as correlations between these inflammatory markers were analyzed. The patients with hematologic malignancies have significantly increased level of inflammatory markers: NLR, PLR, PMR, HLR, SII and dNLR in comparison with age-matched controls. NLR and PLR positively correlate with each other and SII and negatively correlate with HGB. Additionally, PLR has positive correlation with HLR. dNLR has the highest AUC score. For diagnosing hematologic malignancies the AUC of the ROC curve for dNLR was 0.810 with a 95% CI of 0.646-0.975. However, combining these six markers - NLR, PLR, PMR, HLR, SII and dNLR reached the best AUC score - 0.923 with a 95% of CI of 0.778-1.000. Results indicate that NLR, PLR, PMR, HLR, SII and dNLR, which are easily detectable laboratory parameters and reflect systemic inflammatory response can be predictive factors for hematologic malignancies.
The significance of pretreatment anemia in the era of R-IPI and NCCN-IPI prognostic risk assessment tools: a dual-center study in diffuse large B-cell lymphoma patients.
Troppan Katharina T,Melchardt Thomas,Deutsch Alexander,Schlick Konstantin,Stojakovic Tatjana,Bullock Marc D,Reitz Daniel,Beham-Schmid Christine,Weiss Lukas,Neureiter Daniel,Wenzl Kerstin,Greil Richard,Neumeister Peter,Egle Alexander,Pichler Martin
European journal of haematology
BACKGROUND:Anemia is frequently identified at the time of diagnosis in patients with diffuse large B-cell lymphoma (DLBCL); however, studies addressing the prognostic significance of this important clinical parameter are lacking. METHODS:In this dual-center study of patients with DLBCL (n = 556) treated with rituximab-containing regimens, we evaluated the prognostic relevance of anemia at diagnosis in a training set (n = 211) and validated our findings in a second independent patient cohort (n = 345). Using Kaplan-Meier curves as well as univariate and multivariate Cox regression models, we analyzed the impact of anemia on 5-year overall survival (OS) and 5-year disease-free survival (DFS) alongside established prognostic indicators including age, tumor stage, the revised International Prognostic Index (R-IPI), and the recently published NCCN-IPI. The influence of anemia on the predictive accuracy of IPI, R-IPI, and NCCN-IPI prognosis scores was subsequently determined using the Harrell's concordance index. RESULTS:Anemia was an independent predictor of impaired OS and DFS at 5 years in both DLBCL patient cohorts (P < 0.001, log-rank test). In multivariate analysis, hemoglobin level was also a strong and independent prognostic indicator in patients stratified according to R-IPI or NCCN-IPI score. In survival analysis, the estimated concordance index, using IPI, R-IPI, and NCCN-IPI stratification measures (0.69, 0.64, and 0.70, respectively), improved to 0.70, 0.68, and 0.73, respectively, when anemia was also considered. CONCLUSION:In this study, we have demonstrated that anemia at the time of diagnosis is an independent predictor of impaired clinical outcome in DLBCL. Furthermore, consideration of hemoglobin levels may improve the accuracy of recently established prognostic tools in lymphoma. Our data encourage further evaluation of the prognostic utility of this readily accessible biological parameter in prospective clinical trials.
Prognostic impact of red blood cell distribution width in myelodysplastic syndromes.
Shi Zhongxun,Li Bing,Huang Huijun,Qin Tiejun,Xu Zefeng,Zhang Hongli,Fang Liwei,Pan Lijuan,Hu Naibo,Qu Shiqiang,Huang Gang,Gale Robert P,Xiao Zhijian
British journal of haematology