Mu S, Ai L, Fan F, Qin Y, Sun C, Hu Y. Prognostic role of neutrophil-to-lymphocyte ratio in diffuse large B cell lymphoma patients: an updated dose-response meta-analysis.
Cancer Cell Int 2018;
18:119. [PMID:
30166942 PMCID:
PMC6103859 DOI:
10.1186/s12935-018-0609-9]
[Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 08/03/2018] [Indexed: 12/13/2022] Open
Abstract
Background
The neutrophil-to-lymphocyte ratio (NLR), a biomarker for systematic inflammation, has been recently identified as a prognostic factor for various types of both solid and hematologic malignancies. Here we conducted an updated dose–response meta-analysis to investigate whether NLR can be served as a prognostic biomarker in diffuse large B cell lymphoma (DLBCL).
Methods
We systematically searched PubMed, Embase, ISI Web of Science and CNKI for relevant studies. Odds ratios or hazards ratios (HRs) with corresponding 95% confidence intervals (CIs) were pooled to estimate the association between NLR and clinicopathological parameters or survival of cancer patients.
Results
Eleven trials with 2515 DLBCL patients were included in the meta-analysis. The results revealed that elevated pretreatment NLR was significantly associated with elder age, advanced Ann Arbor stage, higher incidence rate of B symptoms and bone marrow involvement, and higher lactate dehydrogenase level, etc. Moreover, increased NLR also predicted poorer overall survival (HR 1.826, 95% CI 1.238–2.692) and progression-free survival/event-free survival (PFS/EFS) (HR 1.591, 95% CI 1.124–2.252). And two-stage dose–response meta-analysis revealed non-linear association between increased NLR and risk of mortality in DLBCL patients.
Conclusion
DLBCL patients with higher NLR are more likely to have poorer prognosis than those with lower NLR.
Electronic supplementary material
The online version of this article (10.1186/s12935-018-0609-9) contains supplementary material, which is available to authorized users.
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