Usefullness of Baseline Neutrophil to Lymphocyte Ratio (NLR) in Hematological Malignancies
DOI:
https://doi.org/10.15379/2408-9877.2016.03.01.03Keywords:
Neutrophil to lymphocyte ratio, Inflammation, Cytokines, Cancer, Metastasis, Predictive, Prognosis.Abstract
Systemic inflammatory response was reported to be a poor prognostic factor in several malignancies. An inexpensive and readily available laboratory tool, neutrophil to lymphocyte ratio (NLR), can be easily obtained from differential blood counts. Current evidence suggests that a baseline NLR may predict the long-term survival results of patients with lymphoproliferative diseases (especially diffuse large B-cell lymphoma). The relationship between systemic inflammation and cancer, and the usefulness of NLR in hematological malignancies will be disscussed in this comprehensive review.
References
Zahorec R. Ratio of neutrophil to lymphocyte counts--rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy 2001; 102: 5-14.
Templeton AJ, McNamara MG, Šeruga B, et al. Prognostic Role of Neutrophil-to-Lymphocyte Ratio in Solid Tumors: A Systematic Review and Meta-Analysis. J Natl Cancer Inst 2014; 106: dju124. http://dx.doi.org/10.1093/jnci/dju124
Porrata LF, Ristow K, Habermann T, Inwards DJ, Micallef IN, Markovic SN. Predicting survival for diffuse large B-cell lymphoma patients using baseline neutrophil/lymphocyte ratio. Am J Hematol 2010; 85: 896-9. http://dx.doi.org/10.1002/ajh.21849
Park JJ, Jang HJ, Oh IY, et al. Prognostic value of neutrophil to lymphocyte ratio in patients presenting with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Am J Cardiol 2013; 111: 636-42. http://dx.doi.org/10.1016/j.amjcard.2012.11.012
Kwon JH, Jang JW, Kim YW, et al. The usefulness of C-reactive protein and neutrophil-to-lymphocyte ratio for predicting the outcome in hospitalized patients with liver cirrhosis. BMC Gastroenterol 2015; 15: 146. http://dx.doi.org/10.1186/s12876-015-0378-z
Posul E, Yilmaz B, Aktas G, Kurt M. Does neutrophil-to-lymphocyte ratio predict active ulcerative colitis? Wien Klin Wochenschr 2015; 127: 262-5. http://dx.doi.org/10.1007/s00508-014-0683-5
Balkwill FR, Mantovani A. Cancer-related inflammation: common themes and therapeutic opportunities. Semin Cancer Biol 2012; 22: 33-40. http://dx.doi.org/10.1016/j.semcancer.2011.12.005
Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature 2008; 454: 436-44. http://dx.doi.org/10.1038/nature07205
Grivennikov SI, Greten FR, Karin M. Immunity, inflammation, and cancer. Cell 2010; 140: 883-99. http://dx.doi.org/10.1016/j.cell.2010.01.025
Balkwill F. Tumour necrosis factor and cancer. Nat Rev Cancer 2009; 9: 361-71. http://dx.doi.org/10.1038/nrc2628
Harrison ML, Obermueller E, Maisey NR, et al. Tumor necrosis factor as a new target for renal cell carcinoma: two sequential phase II trials of infliximab at standard and high dose. J Clin Oncol 2007; 25: 4542-9. http://dx.doi.org/10.1200/JCO.2007.11.2136
Schmielau J, Finn OJ. Activated granulocytes and granulocyte-derived hydrogen peroxide are the underlying mechanism of suppression of t-cell function in advanced cancer patients. Cancer Res 2001; 61: 4756-60.
Rotondo R, Barisione G, Mastracci L, et al. IL-8 induces exocytosis of arginase 1 by neutrophil polymorphonuclears in nonsmall cell lung cancer. Int J Cancer 2009; 125: 887-93. http://dx.doi.org/10.1002/ijc.24448
Zea AH, Rodriguez PC, Atkins MB, et al. Arginase-producing myeloid suppressor cells in renal cell carcinoma patients: a mechanism of tumor evasion. Cancer Res 2005; 65: 3044-8.
Jodele S, Chantrain CF, Blavier L, et al. The contribution of bone marrow-derived cells to the tumor vasculature in neuroblastoma is matrix metalloproteinase-9 dependent. Cancer Res 2005; 65: 3200-8.
Kenny HA, Kaur S, Coussens LM, Lengyel E. The initial steps of ovarian cancer cell metastasis are mediated by MMP-2 cleavage of vitronectin and fibronectin. J Clin Invest 2008; 118: 1367-79. http://dx.doi.org/10.1172/JCI33775
Scapini P, Morini M, Tecchio C, et al. CXCL1/macrophage inflammatory protein-2-induced angiogenesis in vivo is mediated by neutrophil-derived vascular endothelial growth factor-A. J Immunol 2004; 172: 5034-40. http://dx.doi.org/10.4049/jimmunol.172.8.5034
Hasenclever D, Diehl V. A prognostic score for advanced Hodgkin's disease. International Prognostic Factors Project on Advanced Hodgkin's Disease. N Engl J Med 1998; 339: 1506-14. http://dx.doi.org/10.1056/NEJM199811193392104
Alvaro-Naranjo T, Lejeune M, Salvadó-Usach MT, et al. Tumor-infiltrating cells as a prognostic factor in Hodgkin's lymphoma: a quantitative tissue microarray study in a large retrospective cohort of 267 patients. Leuk Lymphoma 2005; 46: 1581-91. http://dx.doi.org/10.1080/10428190500220654
Schreck S, Friebel D, Buettner M, et al. Prognostic impact of tumour-infiltrating Th2 and regulatory T cells in classical Hodgkin lymphoma. Hematol Oncol 2009; 27: 31-9. http://dx.doi.org/10.1002/hon.878
Skinnider BF, Mak TW. The role of cytokines in classical Hodgkin lymphoma. Blood 2002; 99: 4283-97. http://dx.doi.org/10.1182/blood-2002-01-0099
Foss HD, Herbst H, Gottstein S, Demel G, Araujó I, Stein H. Interleukin-8 in Hodgkin's disease: preferential expression by reactive cells and association with neutrophil density. Am J Pathol 1996; 148: 1229-36.
Koh YW, Kang HJ, Park C, et al. Prognostic significance of the ratio of absolute neutrophil count to absolute lymphocyte count in classic Hodgkin lymphoma. Am J Clin Pathol 2012; 138: 846-54. http://dx.doi.org/10.1309/AJCPO46GFKGNXCBR
Lai GG, Lim ST, Tao M, Chan A, Li H, Quek R. Late-onset neutropenia following RCHOP chemotherapy in diffuse large B-cell lymphoma. Am J Hematol 2009; 84: 414-7. http://dx.doi.org/10.1002/ajh.21420
Jazirehi AR, Huerta-Yepez S, Cheng G, Bonavida B. Rituximab (chimeric anti-CD20 monoclonal antibody) inhibits the constitutive nuclear factor {kappa}B signaling pathway in non-Hodgkin's lymphoma B-cell lines: Role in sensitization to chemotherapeutic drug-induced apoptosis. Cancer Res 2005; 65: 264-76.
Alas S, Bonavida B. Rituximab inactivates signal transducer and activation of transcription 3 (STAT3) activity in B non-Hodgkin's lymphoma through inhibition of the interleukin 10 autocrine/paracrine loop and down regulation of Bcl-2 and sensitization of cytotoxic drugs. Cancer Res 2001; 61: 5137-44.
Troppan K, Deutsch A, Gerger A, et al. The derived neutrophil to lymphocyte ratio is an independent prognostic factor in patients with diffuse large B-cell lymphoma. Br J Cancer 2014; 110: 369-74. http://dx.doi.org/10.1038/bjc.2013.763
Keam B, Ha H, Kim TM, et al. Neutrophil to lymphocyte ratio improves prognostic prediction of International Prognostic Index for patients with diffuse large B-cell lymphoma treated with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone. Leuk Lymphoma 2015; 56: 2032-8. http://dx.doi.org/10.3109/10428194.2014.982642
Chang C, Wu SY, Kang YW, et al. High levels of regulatory T cells in blood are a poor prognostic factor in patients with diffuse large B-cell lymphoma. Am J Clin Pathol 2015; 144: 935-44. http://dx.doi.org/10.1309/AJCPUJGMVV6ZF4GG
Ho CL, Lu CS, Chen JH, Chen YG, Huang TC, Wu YY. Neutrophil/lymphocyte ratio, lymphocyte/monocyte ratio, and absolute lymphocyte count/absolute monocyte count prognostic score in diffuse large B-cell lymphoma: Useful prognostic tools in the Rituximab era. Medicine (Baltimore) 2015; 94: e993. http://dx.doi.org/10.1097/MD.0000000000000993
Melchardt T, Troppan K, Weiss L, et al. Independent prognostic value of serum markers in diffuse large B-cell lymphoma in the era of the NCCN-IPI. J Natl Compr Canc Netw 2015; 13: 1501-8.
Bladé J, Rosiñol L, Cibeira MT. Prognostic factors for multiple myeloma in the era of novel agents. Ann Oncol 2008; 19(Suppl 7): vii117-20. http://dx.doi.org/10.1093/annonc/mdn437
Greipp PR, San Miguel J, Durie BG, et al. International staging system for multiple myeloma. J Clin Oncol 2005; 23: 3412-20. http://dx.doi.org/10.1200/JCO.2005.04.242
Neben K, Jauch A, Bertsch U, et al. Combining information regarding chromosomal aberrations t(4;14) and del(17p13) with the International Staging System classification allows stratification of myeloma patients undergoing autologous stem cell transplantation. Haematologica 2010; 95: 1150-7. http://dx.doi.org/10.3324/haematol.2009.016436
Avet-Loiseau H, Durie BG, Cavo M, et al. Combining fluorescent in situ hybridization data with ISS staging improves risk assessment in myeloma: an International Myeloma Working Group collaborative project. Leukemia 2013; 27: 711-7. http://dx.doi.org/10.1038/leu.2012.282
Moreau P, Cavo M, Sonneveld P, et al. Combination of international scoring system 3, high lactate dehydrogenase, and t(4;14) and/or del(17p) identifies patients with multiple myeloma (MM) treated with front-line autologous stem-cell transplantation at high risk of early MM progression-related death. J Clin Oncol: Off J Am Soc Clin Oncol 2014; 32: 2173-80. http://dx.doi.org/10.1200/JCO.2013.53.0329
Kelkitli E, Atay H, Çilingir F, et al. Predicting survival for multiple myeloma patients using baseline neutrophil/lymphocyte ratio. Ann Hematol 2014; 93: 841-6. http://dx.doi.org/10.1007/s00277-013-1978-8
Romano A, Parrinello NL, Consoli ML, et al. Neutrophil to lymphocyte ratio improves the risk assessment of ISS staging in newly diagnosed MM patients treated upfront with novel agents. Ann Hematol 2015; 94: 1875-83. http://dx.doi.org/10.1007/s00277-015-2462-4
Beltran BE, Aguilar C, Quinoñes P, et al. The neutrophil-to-lymphocyte ratio is an independent prognostic factor in patients with peripheral T-cell lymphoma, unspecified. Leuk Lymphoma 2015; 19: 1-5. http://dx.doi.org/10.3109/10428194.2015.1045897
Downloads
Published
Issue
Section
License
Policy for Journals/Articles with Open Access
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work
Policy for Journals / Manuscript with Paid Access
Authors who publish with this journal agree to the following terms:- Publisher retain copyright .
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work .