Prognostic impact of platelet-to-lymphocyte ratio on diffuse large B-cell lymphoma: a meta-analysis

Abstract

Background: Recently, some studies reported the prognostic value of platelet-to-lymphocyte ratio (PLR) in patients with diffuse large B-cell lymphoma (DLBCL), however, the results varied from different studies. Therefore, we performed a meta-analysis to explore the prognostic value of PLR in DLBCL. Methods:A comprehensive literature retrieval was conducted by using PubMed, Embase, Web of Science, the Cochrane Library, the China National Knowledge Infrastructure (CNKI), and Wanfang. Pooled hazard ratio (HR) and 95% confidence interval (CI) were used to evaluate the association of PLR and overall survival (OS) and progression-free survival (PFS). Odd ratios (ORs) and 95% CIs for clinicopathological characteristics were statistically analyzed. Results:Eight studies with 1931 patients were included for meta-analysis. The pooled analysis indicated that elevated PLR was significantly associated with poor OS (HR = 1.73, 95% CI 1.29-2.31, p < 0.001), but not PFS (HR = 0.85, 95% CI 0.57-1.27, p = 0.438). Furthermore, elevated PLR was significantly associated with presentation of B symptoms (OR = 2.27, 95% CI 1.29-3.98, p = 0.004), elevated lactate dehydrogenase (LDH) (OR = 2.76, 95% CI 2.05-3.72, p < 0.001), higher tumor stage (OR = 2.22, 95% CI 1.66-2.98, p < 0.001), and Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≥ 2 (OR = 1.71, 95% CI 1.09-2.69, p = 0.019). However, elevated PLR was not significantly correlated with gender, age or cell of origin. Conclusion:This meta-analysis revealed that PLR may be an effective and noninvasive biomarker for poor prognosis and aggressive disease characteristics for patients with DLBCL.

Prognostic Value of the Platelet-to-Lymphocyte Ratio in Patients With Melanoma: A Meta-Analysis

“…In the current meta-analysis, we identified the PLR as a prognostic factor for OS but not for PFS in patients with melanoma; the non-significant prognostic value for PFS may be the result of the limited studies included. The observations of the current study are in accordance with the findings for bladder cancer (47) and diffuse large B-cell lymphoma (48). Nevertheless, the prognostic value of PLR for PFS needs to be further explored in large-scale prospective trials.…”

Peripheral blood cell ratios as prognostic factors in canine diffuse large B‐cell lymphoma treated with CHOP protocol

“…The study of immune cell subsets from peripheral blood can offer an indication of inflammation and host‐tumour interaction 22 . White blood cell indicators, such as absolute monocyte counts 23 and ratios of lymphocyte‐to‐monocyte (LMR), 24 neutrophil‐to‐lymphocyte (NLR), 25 platelet‐to‐lymphocyte (PLR), 26 either individually or in combination, 27 have been studied as prognostic markers in human DLBCL. In the veterinary field, elevated total neutrophil and monocyte counts are associated with a worse prognosis in dogs treated for multicentric lymphoma with a CHOP‐based protocol 28,29 .…”

“…Low‐platelet count, hypercoagulability and hemostatic disorders have been described in dogs suffering from lymphoma and shown to impact survival 9,28,34 . The PLR has been described as a prognostic predictor in human DLBCL 26 and canine oral tumours. However, in the latter, with no predictive value of outcome 35 .…”

Prognostic Significance of Systemic Immune-Inflammation Index in Patients With Diffuse Large B-Cell Lymphoma

“…A retrospective study indicated that high PLR value was significantly related to poor prognosis to R-CHOP for DLBCL ( 27 ). Meanwhile, a meta-analysis revealed that high PLR was related to poor tumor behavior and poor OS with 1931 individuals, and the PLR might be an effective factor of poor prognosis for patients with DLBCL ( 28 ). A study of 505 patients proved that NLR may be a useful prognostic marker in OS and could predict the progression in patients with DLBCL ( 11 ).…”