Low platelet to lymphocyte ratio and high platelet distribution width have an inferior outcome in chronic lymphocytic leukaemia patients
Streszczenie
Introduction. Chronic lymphocytic leukaemia (CLL) is an incurable disease of the elderly, characterised by gradual accumulation of small mature B lymphocytes which escape apoptosis through inflammatory signals from the microenvironment. Elevated inflammatory markers are associated with very poor prognosis in different types of cancer. Therefore, we examined retrospectively the impact of platelet lymphocyte ratio (PLR) and platelet distribution width (PDW) on 180 CLL patients’ outcome.
Materials and methods. This retrospective study included 180 patients with CLL who were diagnosed and selected among cases referred to the Oncology Center Mansoura University between January 1st, 2008 and June 30th, 2016. All the relevant information was collected from the electronic medical records of the selected patients.
Results. Our results revealed that low PLR ( < 2.5) was more frequently observed in patients with stage C (p < 0.001), with 17p deletion (p = 0.017), and CD38 expression (p = 0.08), but not with seropositive HCV patients (p = 0.2). High PDW (≥18.5 fl) was more frequently associated with intention to treat population (p = 0.038), and CD38 expression (p = 0.068), but not with 17p deletion (p = 0.25) and seropositive HCV patients (p = 0.4). Multivariate analysis for overall survival showed that stage A and low PDW were independent factors for overall survival (p = 0.014 and 0.04 respectively), while high PLR (p = 0.05), and seronegative HCV patients (p = 0.1) lost their significance.
Conclusion. Our data showed that low PLR and high PDW were associated with poor prognostic markers. Stage C-CLL and high PDW were independent predictors of survival.
Słowa kluczowe: chronic lymphocytic leukaemiaplatelet distribution widthplatelet-to-lymphocyte ratio
Referencje
- Bannerji R, Byrd JC. Update on the biology of chronic lymphocytic leukemia. Curr Opin Oncol. 2000; 12(1): 22–29.
- Chiorazzi N, Rai KR, Ferrarini M. Chronic lymphocytic leukemia. N Engl J Med. 2005; 352(8): 804–815.
- Burger J, Tsukada N, Burger M, et al. Blood-derived nurse-like cells protect chronic lymphocytic leukemia B cells from spontaneous apoptosis through stromal cell–derived factor-1. Blood. 2000; 96(8): 2655–2663.
- Tsang M, Parikh SA. A Concise Review of Autoimmune Cytopenias in Chronic Lymphocytic Leukemia. Curr Hematol Malig Rep. 2017; 12(1): 29–38.
- Dührsen U, Augener W, Zwingers T, et al. Spectrum and frequency of autoimmune derangements in lymphoproliferative disorders: analysis of 637 cases and comparison with myeloproliferative diseases*. British Journal of Haematology. 2008; 67(2): 235–239.
- Hallek M, Cheson BD, Catovsky D, et al. International Workshop on Chronic Lymphocytic Leukemia. Guidelines for the diagnosis and treatment of chronic lymphocytic leukemia: a report from the International Workshop on Chronic Lymphocytic Leukemia updating the National Cancer Institute-Working Group 1996 guidelines. Blood. 2008; 111(12): 5446–5456.
- Rai KR, Sawitsky A, Cronkite EP, et al. Clinical staging of chronic lymphocytic leukemia. Blood. 1975; 46(2): 219–234.
- Binet JL, Leporrier M, Dighiero G, et al. A clinical staging system for chronic lymphocytic leukemia.Prognostic significance. Cancer. 1977; 40(2): 855–864, doi: 10.1002/1097-0142(197708)40:2<855::aid-cncr2820400239>3.0.co;2-1.
- Amaya-Chanaga CI, Rassenti LZ. Biomarkers in chronic lymphocytic leukemia: Clinical applications and prognostic markers. Best Pract Res Clin Haematol. 2016; 29(1): 79–89.
- Wang S, Ma Y, Sun L, et al. Prognostic Significance of Pretreatment Neutrophil/Lymphocyte Ratio and Platelet/Lymphocyte Ratio in Patients with Diffuse Large B-Cell Lymphoma. Biomed Res Int. 2018; 2018: 9651254.
- Molica S, Alberti A. Prognostic value of the lymphocyte doubling time in chronic lymphocytic leukemia. Cancer. 1987; 60(11): 2712–2716, doi: 10.1002/1097-0142(19871201)60:11<2712::aid-cncr2820601122>3.0.co;2-1.
- Koller C, Bekele BN, Zhou X, et al. Plasma thrombopoietin compared with immunoglobulin heavy-chain mutation status as a predictor of survival in chronic lymphocytic leukemia. Blood. 2006; 108(3): 1001–1006.
- Yu H, Xu W, Shen QD. Serum levels of soluble CD (23) and thrombopoietin in chronic lymphocytic leukemia. Zhonghua nei ke za zhi. 2008; 47(10): 826–829.
- Zent CS, Kay NE. Autoimmune complications in chronic lymphocytic leukaemia (CLL). Best Pract Res Clin Haematol. 2010; 23(1): 47–59.
- Wang Y, Attar BM, Fuentes HE, et al. Evaluation of the prognostic value of platelet to lymphocyte ratio in patients with hepatocellular carcinoma. J Gastrointest Oncol. 2017; 8(6): 1065–1071.
- Kang HJ, Kim WS, Kim SJ, et al. Phase II trial of rituximab plus CVP combination chemotherapy for advanced stage marginal zone lymphoma as a first-line therapy: Consortium for Improving Survival of Lymphoma (CISL) study. Ann Hematol. 2012; 91(4): 543–551.
- Seo J, Kim WS, Kim JS, et al. Platelet to lymphocyte ratio (PLR) retains independent prognostic significance in advanced stage marginal zone lymphoma patients treated with rituximab, cyclophosphamide, vincristine, and prednisone combination chemotherapy (R-CVP): Consortium for Improving Survival of Lymphoma trial. Blood Res. 2017; 52(3): 200–206.
- Jung SH, Kim JS, Lee WS, et al. Prognostic value of the inverse platelet to lymphocyte ratio (iPLR) in patients with multiple myeloma who were treated up front with a novel agent-containing regimen. Ann Hematol. 2016; 95(1): 55–61.
- Zhang H, Liu Li, Fu S, et al. Higher platelet distribution width predicts poor prognosis in laryngeal cancer. Oncotarget. 2017; 8(29): 48138–48144.
- Santilli F, Boccatonda A, Davì G. Aspirin, platelets, and cancer: The point of view of the internist. Eur J Intern Med. 2016; 34: 11–20.
- Oncel M, Kiyici A, Oncel M, et al. Evaluation of Platelet Indices in Lung Cancer Patients. Asian Pac J Cancer Prev. 2015; 16(17): 7599–7602.
- Gunaldi M, Erdem D, Goksu S, et al. Platelet Distribution Width as a Predictor of Metastasis in Gastric Cancer Patients. J Gastrointest Cancer. 2017; 48(4): 341–346.
- Okuturlar Y, Gunaldi M, Tiken EE, et al. Utility of peripheral blood parameters in predicting breast cancer risk. Asian Pac J Cancer Prev. 2015; 16(6): 2409–2412.
- Yaylaci S, Tosun O, Sahin O, et al. Lack of Variation in Inflammatory Hematological Parameters between Benign Nodular Goiter and Papillary Thyroid Cancer. Asian Pac J Cancer Prev. 2016; 17(4): 2321–2323.
- Cui MM, Li Na, Liu X, et al. Platelet distribution width correlates with prognosis of non-small cell lung cancer. Sci Rep. 2017; 7(1): 3456.
