Prognostic Role of Neutrophil to Lymphocyte Ratio at Diagnosis in Patients with Diffuse Large B-Cell Lymphoma

Background: Aim to investigate the prognostic value of neutrophil to lymphocyte ratio (NLR) at the time of diagnosis, which is an inexpensive and easily accessible parameter, compared to factors known as prognostic value (such as R-IPI and NCCN-IPI) in patients with diffuse large B-cell lymphoma (DLBCL). Aim: Prognostic value of NLR at diagnosis in DLBCL. Methods: A hundred (100) newly diagnosed DLBCL patients were included. The correlations between the NLR with clinical characteristics, treatment response, and survival were analyzed. The NLR cut-off value was taken at 3.5 accord & imath;ng to the receiver operating characteristic curve. Results: There were 53 patients with an NLR of 3.5 and 47 patients with an NLR < 3.5. Patients with NLR >= 3.5 had a complete response (CR) rate of 66.0% (n = 31/47), and patients with NLR < 3.5 had a CR rate of 98.1% (n = 51/52). The median progression-free survival (PFS) was 132.5 months (95%CI 103.1-162.0). PFS in the NLR >= 3.5 group (36 months) was significantly (P < 0.000) shorter than in the NLR < 3.5 group (185 months). The median overall survival (OS) for NLR >= 3.5 and NLR < 3.5 was 79.2 months (95% CI 51.6-106.8) and 197.8 months (95% CI 173.2-222.5), respectively. NLR >= 3.5 was associated with worse OS than NLR < 3.5 (P = 0.000). The high value of NLR (>= 3.5) had lower treatment response rates, higher relapse, and death rates. Conclusion: High NLR was associated with poor treatment response, PFS, and OS. NLR can be used as a cost-effective and easy-to-interpret prognostic marker in DLBCL patients.