Elevated Preoperative Neutrophil–Lymphocyte Ratio is Predictive of a Poorer Prognosis for Pediatric Patients with Solid Tumors

Nayak, Agnish; McDowell, Dermot T.; Kellie, Stewart J.; Karpelowsky, Jonathan

doi:10.1245/s10434-017-6006-0

Cited by 22 publications

(23 citation statements)

References 36 publications

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“…Unlike in other studies, the present study was conducted with pediatric patients, thus NLR may be found in the malignancy group was lower than those reported in adult patients. In accordance with our work, the studies investigate the prognostic value of NLR in pediatric populations with solid tumors and sarcomas, the cut-off value of 2.5 and 2 respectively for NLRs were accepted (19,20).…”

Section: Discussionsupporting

confidence: 70%

Importance of neutrophil-lymphocyte ratio in the management of children with cervical lymphadenopathy

Bezgin¹,

Çakabay²,

Al³

et al. 2019

Acta Oncol Tur.

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Servikal lenfadenopati, pediatrik hastalarda sık görülen bir semptomdur. Ek prediktif faktörlerin arttırılması, malign nedenleri iyi huylu nedenlerden ayırmak için kritik öneme sahiptir. Bu çalışmada, servikal lenfadenopatili çocukların değerlendirilmesinde nötrofil lenfosit oranının klinik önemini değerlendirmeyi amaçladık. YÖNTEM ve GEREÇLER: Çalışmaya 18 yaş altı 86 çocuk hasta dahil edildi. Üç grup oluşturuldu ve kontrol grubu olan grup 1 (30 çocuk) hastanemizde sünnet veya inguinal herni nedeniyle opere edilen hastalardan oluşmaktadır. Grup 2 çalışma grubu (30 çocuk) olup kulak burun boğaz ve/veya pediatric hematoloji-onkoloji polikliniklerinde kronik servikal lenfadenopati nedeniyle değerlendirilen hastalardan oluşmaktadır. Grup 3 (26 çocuk) ise Hodgkin lenfoma tanılı hastalardan oluşmaktadır. Tüm grupların nötrofil-lenfosit oranları analiz edilmiştir. BULGULAR: Ortalama nötrofil-lenfosit oranları açısından grup 1 ve grup 3 (p <0.05) ile grup 2 ve grup3 (p <0.05) arasında anlamlı farklılık saptanmışken grup1 ve grup 2 arasında anlamlı farklılık saptanmamıştır (p >0.05). ROC eğrisinde maksimum kombine hassasiyete ve özgüllüğe karşılık gelen 1.2 nötrofil-lenfosit oranı değerine dayanarak bir alıcı ROC analizi yapıldı ve % 40 hassasiyet ve % 33 özgüllük belirlendi. TARTIŞMA ve SONUÇ: Bu çalışmada lenfomalı grupta diğer gruplara göre yüksek nötrofil-lenfosit oranları ortaya koymaktadır. Ancak düşük özgüllük ve hassasiyet değerleri, maligniteyi tespit etmek için parametrenin güvenilir olarak kullanımını kısıtlar.

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Section: Discussionsupporting

confidence: 70%

Importance of neutrophil-lymphocyte ratio in the management of children with cervical lymphadenopathy

Bezgin¹,

Çakabay²,

Al³

et al. 2019

Acta Oncol Tur.

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“…demonstrated an independent relationship between high NLR and shorter OS in neuroblastoma [17]. Similar findings were observed in paediatric soft tissue sarcomas, and salivary malignancies [18,19].…”

Section: P R E P R I N T Discussionsupporting

confidence: 66%

Systemic inflammatory markers and serum lactate dehydrogenase predict survival in patients with Wilms tumour

et al. 2021

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IntroductionThe markers of inflammation such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) have been found associated with survival in cancer patients. The aim of the current study was to establish the prognostic significance of simple laboratory markers of systemic inflammation in paediatric patients diagnosed with Wilms tumour. Additionally, we aimed to compare the CBC parameters of WT patients and the non-oncological control group.Material and methodsThe study group included 83 children diagnosed with WT. Clinicopathological data, as well as complete blood count (CBC), C-reactive protein (CRP) and lactate dehydrogenase (LDH) levels at diagnosis, were obtained. Additionally, the laboratory results of healthy 63 control paediatric patients were collected. Uni- and multivariate proportional Cox’s hazard analyses were computed to create a model predicting relapse-free survival (RFS) and overall survival (OS) in the study group.ResultsHigh CRP, LDH, and NLR were associated with a higher stage of WT and shorter RFS; whereas all parameters correlated with OS. In multivariate analysis, only LDH levels had adverse significance in predicting RFS. C-reactive protein and LMR retained their prognostic value in the multivariate model predicting OS. Comparing the WT group with controls, high LDH, high CRP, high NLR, and high PLR were associated with WT presence.ConclusionsPreoperative LDH, CRP, NLR, PLR, and LMR have significant prognostic value in patients with WT independently of age and stage. Combined low CRP and high LMR identified the group of patients with excellent OS. Patients with high LDH were characterized by the highest risk of relapse.

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“…Monitoring lymphocyte levels during and after chemotherapy in hematopoietic and solid tumors generally showed increased EFS in patients with higher lymphocyte counts at diagnosis as well as after induction chemotherapy [42,[47][48][49] In addition, fast monocyte recovery after chemotherapy is predictive for EFS in patients with leukemias and lymphomas [50,51]. In line with these data, an elevated neutrophil to lymphocyte ratio after chemotherapy, but before surgical resection of the NBL tumor, was associated with decreased OS [52].…”

Section: Chemotherapymentioning

confidence: 62%

Monitoring Immune Responses in Neuroblastoma Patients during Therapy

Szanto

Cornel

Vijver

et al. 2020

Cancers

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Neuroblastoma (NBL) is the most common extracranial solid tumor in childhood. Despite intense treatment, children with this high-risk disease have a poor prognosis. Immunotherapy showed a significant improvement in event-free survival in high-risk NBL patients receiving chimeric anti-GD2 in combination with cytokines and isotretinoin after myeloablative consolidation therapy. However, response to immunotherapy varies widely, and often therapy is stopped due to severe toxicities. Objective markers that help to predict which patients will respond or develop toxicity to a certain treatment are lacking. Immunotherapy guided via immune monitoring protocols will help to identify responders as early as possible, to decipher the immune response at play, and to adjust or develop new treatment strategies. In this review, we summarize recent studies investigating frequency and phenotype of immune cells in NBL patients prior and during current treatment protocols and highlight how these findings are related to clinical outcome. In addition, we discuss potential targets to improve immunogenicity and strategies that may help to improve therapy efficacy. We conclude that immune monitoring during therapy of NBL patients is essential to identify predictive biomarkers to guide patients towards effective treatment, with limited toxicities and optimal quality of life.

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Elevated Preoperative Neutrophil–Lymphocyte Ratio is Predictive of a Poorer Prognosis for Pediatric Patients with Solid Tumors

Abstract: An elevated NLR is prognostic of a poorer outcome for pediatric patients with solid tumors and potentially represents an independent, universal adjunct prognosticator in such cases.

Cited by 22 publications

References 36 publications

Importance of neutrophil-lymphocyte ratio in the management of children with cervical lymphadenopathy

Importance of neutrophil-lymphocyte ratio in the management of children with cervical lymphadenopathy

Systemic inflammatory markers and serum lactate dehydrogenase predict survival in patients with Wilms tumour

Monitoring Immune Responses in Neuroblastoma Patients during Therapy

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