| Purpose:B-cell chronic lymphoproliferative disorders(B-CLPDs)are collection of mature B-cell clonal proliferative disorders involving bone marrow or peripheral blood.Common clinical subtypes include:chronic lymphocytic leukemia/small lymphocytic lymphoma(CLL/SLL),follicular lymphoma(FL),mantle cell lymphoma(MCL),marginal zone lymphoma(MZL)and lymphoplasmacytic lymphoma/Waldenstroms macroglobulinemia(LPL/WM).B-CLPDs patients have similar clinical characteristics with slow clinical progress and indolent disease course.They can transform into invasive lymphoma and can be remission after treatment,but difficult to cure.In addition,the clinical course of all B-CLPDs subtypes are characterized by heterogeneity,so early identification of patient risk stratification is critical for the selection of individualized treatment.In recent years,the relationship between inflammation and tumor has been widely concerned.Mean platelet volume to platelet ratio(MPR),C-reactive protein(CRP)and CRP kinetics have been shown to be prognostic factors in a variety of cancers.However,the prognostic role of the above biomarkers in B-CLPDs patients remains unclear.The purpose of this study was to evaluate the relationship between MPR,CRP,CRP kinetics and Overall survival(OS),disease-free survival(DFS),progression-free survival(PFS)of B-CLPDs patients,and to determine the prognostic values of these biomarkers in B-CLPDs patients.Methods:All patients admitted to hematology department of Shandong Provincial Hospital and diagnosed with B-CLPDs between January 2013 and December 2019 were involved in this retrospective cohort study.Receiver operating curve(ROC)was used to determine the optimal cut-off values of the above biomarkers.The correlation between these biomarkers and clinicopathological parameters was evaluated by Pearson chi-square test.The Kaplan-Meier survival curve and log-rank test were used for survival analysis.Cox regression analysis was used to determine the prognostic significance of each clinicopathologic factor.Results:A total of 209 B-CLPDs patients were involved in this study,including 61 CLL/SLL patients,67 FL patients,19 MCL patients,41 MZL patients and 21 LPL/WM patients.Overall,the male to female ratio of B-CLPDs patients was 1.40:1 and the median age of diagnosis was 59 years.With the median follow-up time of 29 months,21 patients died,36 patients experienced disease recurrence and 43 patients suffered disease progression.Univariate analysis showed that MPR>0.105×10-9fl,CRP>4.075mg/L and CRP kinetics were adverse prognostic factors in B-CLPDs patients,which had predictive effects on OS,DFS and PFS.Multivariate analysis showed that MPR>0.105× 10-9fl(HR:7.420,95%CI:3.044-18.090,p<0.001)and CRP kinetics(HR:5.080,95%CI:2.567-10.055,p<0.001)were independent prognostic factors for OS in B-CLPDs patients.MPR>0.105 × 10-9fl(DFS:HR:2.463,95%CI:1.95-5.079,p=0.015.PFS:HR:2.263,95%CI:1.161-4.410,p=0.016)and CRP kinetics(DFS:HR:2.967,95%CI:1.883-4.676,p<0.001.PFS:HR:2.767,95%CI:1.830-4.181,p<0.001)were also independent prognostic factors for DFS and PFS in B-CLPDs patients.Conclusion:MPR level and CRP kinetics are independent prognostic factors in B-CLPDs patients,which can predict OS,DFS and PFS in B-CLPDs patients.This study provides easily accessible and cost-effective prognostic indicators for patients with B-CLPDs,and their clinical application are worth looking forward to. |
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