Neutrophil to Lymphocyte Ratio - Not an Independent Prognostic Factor in Patients with the Myelodysplastic Syndrome

Abstract

Purpose: Neutrophil-to-lymphocyte ratio (NLR) was evaluated as a potential prognostic factor in patients with myelodysplastic syndrome (MDS). Materials and Methods: Between December 2009 and April 2014, 14 female (35%) and 26 male (65%) MDS patients who were followed up in our hematology clinic were included in the study for NLR during diagnosis. Division was into two groups according to the NLR, and the correlation with mortality was evaluated. The prognostic significance of NLR regarding treatment outcome was also evaluated with adjustment for known confounding risk factors. Results: The mortality rate of the patient group was 55%, and median survival was 18 months. There was no significant correlation between mortality and NLR at a median value of 1.8 (p=0.75). Thrombocytopenia was observed to increase mortality (p=0.027), and there was a significant correlation between mortality and pancytopenia (p=0.017). Conclusions: This first study of NLR and mortality did not show any significant correlation . In centres with limited access to genetic evaluation for the presence of pancytopenia and/or thrombocytopenia at the time of diagnosis, a platelet level less than 50×10 9 /l may be poor prognostic markers in MDS patients.

Adult Primary Myelodysplastic Syndrome: Experience from a Tertiary Care Center in Pakistan

“…In this study, which consisted of 45 patients with primary MDS, the male to female ratio is 1.7:1 which is consistent with the well known male preponderance which has been reported from other regional and international studies (Akinci et al, 2014;Rashid et al, 2014).…”

“…The presence of pancytopenia and/or thrombocytopenia at the time of diagnosis in MDS patients has been described as poor prognostic markers (Akinci et al, 2014). In the present study pancytopenia and bicytopenia were noted in 40% and 31.1% respectively, more or less similar to earlier studies reported from Pakistan (71.7% and 26%) and turkey (55% and 40%) (Ehsan et al, 2010;Akinci et al, 2014).…”

“…Myelodysplastic syndrome (MDS) are a group of clonal disorders characterized by ineffective hematopoiesis, cytopenias, in the presence of hypercellular bone marrow with morphological dysplastic changes (Newman et al, 2012;Akinci et al, 2014). Myelodysplasia is a heterogeneous disease with an increased risk of leukemic transformation, overall 40% of patients will transform to AML during the disease course (Chevassut et al, 2011;Gao et al, 2015).…”