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MIPI as a superior prognostic tool in mantle cell lymphoma compared to monocyte-lymphocyte, neutrophil-lymphocyte and platelet-lymphocyte ratios

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Abstract Background Monocyte-lymphocyte, neutrophil-lymphocyte and platelet-lymphocyte ratio are considered prognostic tools of overall survival (OS) in several hematologic and solid tumors. All these elements have been implicated as biomarkers of… Click to show full abstract

Abstract Background Monocyte-lymphocyte, neutrophil-lymphocyte and platelet-lymphocyte ratio are considered prognostic tools of overall survival (OS) in several hematologic and solid tumors. All these elements have been implicated as biomarkers of tumor microenvironment and immune homeostasis. Mantle cell lymphoma (MCL) is a relatively uncommon subtype of lymphoid malignancy (5%–7% of malignant lymphoma) but could be very aggressive. Mantle Cell Lymphoma International Prognostic Index (MIPI) is the only validated prognostic tool for these patients. The aim of this study assessed the prognostic significance of monocyte-lymphocyte, neutrophil-lymphocyte and platelet-lymphocyte ratio as prognostic biomarkers for MCL. Methods An observational retrospective study was conducted and included a total all the patients diagnosed with MCL between 2008-2018 in our hematologic center. The ratios were calculated, and statistical analysis were assessed using Kaplan-Meier method, log-rank test and Cox regression. All the analyses were performed using SPSS. Results A total of 52 patients were included, 75% were male, with the median age at diagnosis being 67 years-old (max 94, min 36 years old). 77% of the patients had an ECOG PS 0-1, 67% had a high risk MIPI and 73% were a stage IV disease at diagnosis. Kaplan-Meier analysis showed that MIPI score significantly predicts the OS of the patients, with the higher scores being associated with inferior OS (p = 0,02). The same did not happen with the monocyte-lymphocyte ratio (p = 0,5), neutrophil-lymphocyte ratio (p = 0,4) and platelet-lymphocyte ratio (p = 0,3). The same results were showed in cox regression, MIPI score remained the only score associated with OS (HR, 0,35; 95% CI 0,132-0,962). Conclusions In conclusion, this study fails to identify monocyte-lymphocyte, neutrophil-lymphocyte and platelet-lymphocyte ratios as prognostic tools and support MIPI as predictor of the survival outcome in MCL patients and its ability to identify high-risk patients. Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest.

Keywords: monocyte lymphocyte; lymphocyte neutrophil; platelet lymphocyte; neutrophil lymphocyte; lymphocyte

Journal Title: Annals of Oncology
Year Published: 2019

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