Complete Blood Count Score Model Predicts Inferior Prognosis in Primary Central Nervous System Lymphoma

Abstract

BackgroundPrimary central nervous system lymphoma (PCNSL), an aggressive type of non-Hodgkin lymphoma, has a poor prognosis. Currently available prognostic scoring systems are inadequate. We therefore aimed to investigate the predictive values of complete blood counts (CBCs) in PCNSL.Materials and MethodsThe cohort of this retrospective study comprised 73 PCNSL patients. The predictive values of selected CBCs, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune inflammation index (SII), and systemic inflammation response index (SIRI), were analyzed.ResultsAges and Memorial Sloan Kettering Cancer Center (MSKCC) scores of PCNSL patients correlated with NLR, PLR, and SII values (p <0.05). Both age and MSKCC scores correlated with inferior progression-free survival (PFS) and overall survival (OS) (p <0.05). High NLR, PLR, SII, and SIRI were significant predictors of shorter PFS and OS (p <0.05). NLR, PLR, SII, and SIRI were integrated to generate a “CBC score” model that accurately stratified PCNSL patients into three risk groups. The median PFS for low-risk, intermediate-risk, and high-risk groups were 24 ((12.458–35.542), 17 (10.626–23.374), and 9 (8.893–19.107) months, respectively (p = 0.011), and the median OS were 33 (19.175–46.825), 18 (16.368–19.632), and 9 (6.521–11.479) months, respectively (p = 0.008). Multivariate Cox regression model showed that MSKCC score (hazard ratio (HR) = 3.791, p <0.001), PLR (HR = 1.003, p = 0.013), and CBC score (HR = 1.873, p = 0.011) were independent predictors for PFS, whereas MSKCC score (HR = 4.128, p <0.001), PLR (HR = 1.003, p = 0.005), and CBC score (HR = 1.907, p = 0.004) were independent predictors for OS.ConclusionThe CBC score model may be a promising predictive system for PCNSL patients.

Proposed new prognostic model using the systemic immune-inflammation index for primary central nervous system lymphoma: A prospective-retrospective multicohort analysis

“…Meanwhile, it was also demonstrated in the validation cohort. In terms of the finding for high SII, it was associated with worse survival, which is consistent with previous reports of DLBCL ( 16 , 17 ) and PCNSL ( 13 , 14 ). Interestingly, the patients with low SII also had worse outcomes, which has not been reported in other studies.…”

“…Systemic immune-inflammation index was reported to be associated with OS in PCNSL ( 13 , 14 ) and DLBCL ( 15 – 17 ) in a linear manner. However, a U-shaped relationship was first demonstrated here, which is different from previous studies ( 5 , 25 ).…”

“…Lymphocytes play a crucial role in tumor defense by inducing cytotoxic cell death ( 12 ). Therefore, SII has been reported to predict outcomes in patients with PCNSL ( 13 , 14 ) and diffuse large b-cell lymphoma (DLBCL; 15 – 17 ). Currently, it is unknown how best to use SII, either alone or in combination with MSKCC factors, to estimate prognosis in PCNSL.…”

A Risk Model Composed of Complete Blood Count, BRAF V600E and MAP2K1 Predicts Inferior Prognosis of Langerhans Cell Histiocytosis in Children

“…They established that the respective median PFS for low-, intermediate-, and high-risk groups were not reached, 16 and 7 months, while respective median OS for the 3 groups were not reached, 46 and 20 months. Our previous study also established a CBCs model incorporating NLR, PLR, SII, and SIRI for primary central nervous system lymphoma, which accurately predicted the median PFS and median OS (10). Findings of this study are consistent with the previous findings, indicating that the new risk model could be used for prognosis prediction in childhood LCH.…”

“…Systemic inflammatory responses and host immunity are closely associated with cancer development and prognostic outcomes (8). Complete blood counts (CBC) combined with each other, such as platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), systemic inflammation response index (SIRI), and systemic immune inflammation index (SII), can be used as prognostic predictors for cancers (9,10). However, the significance of CBCs in LCH should be evaluated further.…”