| [Objective] To explore the prognostic value of the peripheral blood platelet/absolute lymphocyte count ratio(PLR)、absolute neutrophil count/absolute lymphocyte count ratio(NLR)in adult Classic Hodgkin’s lymphoma(CHL).[Method] 1.96 patients with adult Classic Hodgkin’s lymphoma(CHL)who were initially treated in our hospital from January 2010 to October 2018 were enrolled.We further followed up the patients’ outcomes and recorded the prognostic factors.2.SPSS 24.0 software was used to draw the Receiver Operating Characteristic curve(ROC)to determine the optimal cut-off points of PLR and NLR.In addition,these patients were divided according to the cut-off point for further analysis.3.Kaplan-meier method was performed to analysis the survival of these patients.4.Univariate and multivariate prognostic analysis were respectively performed using the COX proportional hazard model.[Results] 1.These 96 patients with adult CHL ranged in age from 18 to 75 years,with a median age of 30 years,including 51 males,45 females,36 patients with stage I-II,and 60 patients with stage III-IV.All patients received ABVD or AVD based chemotherapy regimen.By the end of the follow-up,83 patients(86.5%)were still alive while 13 patients(13.5%)were died.The 5-year overall survival(OS)rate was90.6%,and the 5-year progression-free survival(PFS)rate was 80.2%.2.The optimal cut-off points for PLR and NLR determined by the ROC curve were 266 and 6.4,respectively.3.Univariate analysis showed: lymphopenia,IPS≥4,NLR≥6.4,PLR≥266 and other factors significantly shortened the PFS(P = 0.004,P = 0.023,P = 0.002,P =0.028)and OS(P=0.004,P=0.019,P=0.002,P=0.014)in patients with adult CHL.Patients with B symptoms(P = 0.022)and in stage IV(P = 0.01)had significantly shorter OS.Patients with IPI ≥ 2(P = 0.008)have shorter PFS,as well.4.Multivariate analysis revealed: Only disease in stage IV(P=0.018)was an independent adverse factor affecting the PFS in patients with adult CHL.Yet,neither PLR ≥ 266 nor NLR ≥ 6.4 can be considered as a poor prognostic factor in patients with CHL.5.Compared with the low-PLR group,patients in the high-PLR group had a lower 5-year OS rate(81.4% vs 98.1%,P = 0.01).Furthermore,patients in the high-NLR group had a lower 5-year OS rate than those in the low-NLR group(77.4%vs 96.9%,P = 0.002).6.Subgroup analysis of patients with advanced disease stage(III-IV)demonstrated: Patients in the high-NLR group held lower 5-year OS rate(73.9% vs100%,P=0.002)and 5-year PFS rate(52.2% vs 86.5%,P=0.009)than those in lowNLR group.Similarly,the 5-year OS rate was lower in the high-PLR group than in the low-PLR group(80.6% vs 100%,P=0.018).What’s more,in the IPS<4 patient group,the 5-year OS rate(82.4% vs 98.2%,P=0.02)and the 5-year PFS rate(70.6% vs94.5%,P=0.012)were lower in patients with high NLR than those with low NLR.The same goes for the patients in high-PLR group whose 5-year PFS rate were lower than the low-PLR group(77.8% vs 95.6%,P = 0.042).[Conclusions] 1.The overall prognosis of adult patients with classic Hodgkin’s lymphoma(CHL)is favorable.2.Patients with PLR≥266 or NLR≥6.4 are more likely to encounter with events such as recurrence,disease progression or death.3.High PLR or high NLR has a large prognostic reference value in patients with stage III-IV disease and IPS<4.4.PLR or NLR can be used as a supplementary prognostic reference indicator for international prognostic score(IPS). |
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