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Leuk Lymphoma. 2019 Jul 1:1-9. doi: 10.1080/10428194.2019.1633628. [Epub ahead of print]

The neutrophil/lymphocyte ratio ≥3.5 is a prognostic marker in diffuse large B-cell lymphoma: a retrospective analysis from the database of the Italian regional network 'Rete Ematologica del Lazio per i Linfomi' (RELLI).

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a Ematologia, Trapianto di cellule staminali , Università Campus Bio Medico di Roma , Rome , Italy.
b Fondazione Policlinico Universitario A. Gemelli IRCCS, Istituto di Ematologia, Università Cattolica del Sacro Cuore , Rome , Italy.
c UO di Ematologia e Trapianto di Cellule Staminali, IRCCS Istituto Nazionale Tumori Regina Elena , Rome , Italy.
d UO Ematologia , Policlinico Tor Vergata Roma , Rome , Italy.
e Dipartimento di Biotecnologie Cellulari e Ematologia , Università Sapienza Roma , Rome , Italy.
f Anatomia Patologica , Azienza Ospedaliera Universitaria, Sant'Andrea , Rome , Italy.
g Ematologia , Azienza Ospedaliera Universitaria, Sant'Andrea , Rome , Italy.
h U.O.C Ematologia e Trapianti CSE - A.O. San Camillo Forlanini , Rome , Italy.
i S.C. Ematologia e Trapianto di Cellule Staminali, Ospedale San Giovanni Addolorata , Rome , Italy.
j Ematologia, Ospedale Sant'Eugenio , Rome , Italy.
k Ematologia , Polo Universitario Pontino , Latina , Italy.
l Ospedale Nuovo Regina Margherita , Rome , Italy.


In solid tumors and lymphomas, the neutrophil/lymphocyte (N/L) ratio at diagnosis has been shown to be a prognostic factor. The aim of our study was to validate the originally reported N/L ratio cut-point of 3.5 in patients with diffuse large B-cell lymphoma (DLBCL) registered in an Italian real-life database. The prognostic role of the N/L ratio at diagnosis on event-free survival (EFS) and overall survival (OS) was assessed in 505 patients with DLBCL. Patients with an N/L ratio <3.5 (n = 249) had a 4-year EFS probability of 76% and OS probability of 86%, significantly higher than the 4 year EFS rate of 48% and OS rate of 64% in patients with N/L ratio ≥3.5 (n = 256, both p<.0001). The N/L ratio was an independent prognostic factor in the multivariate analysis including the IPI score, and could separate patients with a low/intermediate risk IPI (IPI <3).


DLBCL; N/L ratio; R-CHOP; cancer; lymphoma

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