Background The neutrophil to lymphocyte ratio (NLR) and the lymphocyte to monocyte ratio (LMR) can reflect both the myeloid dysfunction and T-cell immune suppression and have prognostic significance.Methods In 771 newly diagnosed advanced-stage Hodgkin Lymphoma (HL) patients we evaluated the baseline values of NLR and LMR as predictors of clinical outcome. According to the multicenter prospective phase II GITIL-HD0607 trial, all patients received two ABVD courses and if PET-2 negative received four additional ABVD cycles while if PET-2-positive patients were randomized to either BEACOPP escalated (Be) plus BEACOPP baseline (Bb) (4 + 4 courses) or Be + Bb (4 + 4) and Rituximab. PET scans were centrally reviewed by an expert panel by Blinded Independent Central Review.Results Higher NLR and lower LMR were associated with a PET-2 positivity and failure to achieve long-term disease control, respectively. By univariate and multivariate analysis, large nodal mass (>7 cm), IPS >= 3, NLR > 6 were strong independent predictors of early PET-2 response after ABVD. Only NLR > 6 and IPS >= 3 were strong independent predictors of outcome at diagnosis; however, when PET-2 status was added, only PET-2-positive status and IPS >= 3 were independent predictors of PFS. Focusing on PET-2-negative patients, those with NLR > 6 had an inferior 3-year PFS compared to patients with NLR <= 6 (84% vs 89% months, P = .03).Conclusion In advanced-stage HL patients treated with a PET-2-driven strategy, IPS >= 3 and NLR > 6 are independent predictors of outcome at diagnosis while the presence of large nodal mass, IPS >= 3, and NLR > 6 at diagnosis are independent predictors of early ABVD response.

The neutrophil to lymphocyte ratio (NLR) and the presence of large nodal mass are independent predictors of early response: A subanalysis of the prospective phase II PET-2-adapted HD0607 trial

Romano, Alessandra
Primo
Conceptualization
;
Di Raimondo, Francesco;
2020

Abstract

Background The neutrophil to lymphocyte ratio (NLR) and the lymphocyte to monocyte ratio (LMR) can reflect both the myeloid dysfunction and T-cell immune suppression and have prognostic significance.Methods In 771 newly diagnosed advanced-stage Hodgkin Lymphoma (HL) patients we evaluated the baseline values of NLR and LMR as predictors of clinical outcome. According to the multicenter prospective phase II GITIL-HD0607 trial, all patients received two ABVD courses and if PET-2 negative received four additional ABVD cycles while if PET-2-positive patients were randomized to either BEACOPP escalated (Be) plus BEACOPP baseline (Bb) (4 + 4 courses) or Be + Bb (4 + 4) and Rituximab. PET scans were centrally reviewed by an expert panel by Blinded Independent Central Review.Results Higher NLR and lower LMR were associated with a PET-2 positivity and failure to achieve long-term disease control, respectively. By univariate and multivariate analysis, large nodal mass (>7 cm), IPS >= 3, NLR > 6 were strong independent predictors of early PET-2 response after ABVD. Only NLR > 6 and IPS >= 3 were strong independent predictors of outcome at diagnosis; however, when PET-2 status was added, only PET-2-positive status and IPS >= 3 were independent predictors of PFS. Focusing on PET-2-negative patients, those with NLR > 6 had an inferior 3-year PFS compared to patients with NLR <= 6 (84% vs 89% months, P = .03).Conclusion In advanced-stage HL patients treated with a PET-2-driven strategy, IPS >= 3 and NLR > 6 are independent predictors of outcome at diagnosis while the presence of large nodal mass, IPS >= 3, and NLR > 6 at diagnosis are independent predictors of early ABVD response.
PET-2
biomarkers
hodgkin lymphoma
neutrophil to lymphocyte ratio
Adolescent
Adult
Antineoplastic Combined Chemotherapy Protocols
Clinical Decision-Making
Female
Hodgkin Disease
Humans
Italy
Lymph Nodes
Lymphocyte Count
Male
Middle Aged
Neoplasm Staging
Predictive Value of Tests
Prospective Studies
Time Factors
Treatment Outcome
Young Adult
Lymphocytes
Neutrophils
Positron-Emission Tomography
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11769/542281
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