Neutrophil-to-lymphocyte ratio as a prognostic indicator of mortality in Polycythemia Vera: insights from a prospective cohort analysis

IF 12.9 1区 医学 Q1 HEMATOLOGY Blood Cancer Journal Pub Date : 2024-11-06 DOI:10.1038/s41408-024-01176-7
Tiziano Barbui, Alessandra Carobbio, Arianna Ghirardi, Francesca Fenili, Maria Chiara Finazzi, Marta Castelli, Alessandro M. Vannucchi, Paola Guglielmelli, Alessandro Rambaldi, Naseema Gangat, Ayalew Tefferi
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Abstract

We analyzed the neutrophil-to-lymphocyte ratio (NLR) in 1508 patients with PV and found that those with an NLR ≥ 5 were generally older, had a longer disease history, and had higher cardiovascular risk factors, more arterial thrombosis, and more aggressive blood counts, indicating a more proliferative disease. NLR was an accurate predictor of mortality, with patients with NLR ≥ 5 having significantly worse overall survival and more than twice the mortality rate compared to those with NLR < 5. Multivariable models confirmed that increasing age, previous venous thrombosis and NLR ≥ 5 were strong predictors of death, further influenced by cardiovascular risk factors. We examined the interaction between NLR and the number of cardiovascular risk factors and found a progressive trend of increased mortality risk for NLR values ≥ 5 in addition to the presence of more than one risk factor. In conclusion, patients with NLR ≥ 5 require careful monitoring and management of cardiovascular risk factors because they increase mortality when associated with progressive levels of NLR.

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中性粒细胞与淋巴细胞比率作为多发性红细胞症患者死亡率的预后指标:前瞻性队列分析的启示
我们分析了 1508 名中性粒细胞-淋巴细胞比值(NLR),发现 NLR≥5 的中性粒细胞-淋巴细胞比值患者一般年龄较大,病史较长,心血管危险因素较高,动脉血栓形成较多,血细胞计数较高,表明疾病的增殖性较强。NLR 是预测死亡率的准确指标,与 NLR < 5 的患者相比,NLR ≥ 5 的患者总生存率明显更差,死亡率是后者的两倍多。多变量模型证实,年龄增加、既往静脉血栓形成和 NLR ≥ 5 是死亡的有力预测因素,心血管风险因素对其影响更大。我们研究了 NLR 与心血管风险因素数量之间的交互作用,发现除了存在一个以上的风险因素外,NLR 值≥ 5 的死亡风险呈逐渐增加的趋势。总之,NLR ≥ 5 的患者需要仔细监测和管理心血管风险因素,因为当这些因素与渐进的 NLR 水平相关联时,会增加死亡率。
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来源期刊
CiteScore
16.70
自引率
2.30%
发文量
153
审稿时长
>12 weeks
期刊介绍: Blood Cancer Journal is dedicated to publishing high-quality articles related to hematologic malignancies and related disorders. The journal welcomes submissions of original research, reviews, guidelines, and letters that are deemed to have a significant impact in the field. While the journal covers a wide range of topics, it particularly focuses on areas such as: Preclinical studies of new compounds, especially those that provide mechanistic insights Clinical trials and observations Reviews related to new drugs and current management of hematologic malignancies Novel observations related to new mutations, molecular pathways, and tumor genomics Blood Cancer Journal offers a forum for expedited publication of novel observations regarding new mutations or altered pathways.
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