A Multi-Institutional Validation of the Prognostic Value of the Neutrophil-To-Lymphocyte Ratio in Patients with Diffuse Large B-Cell Lymphoma: A Study from The Latin American Group of Lymphoproliferative Disorders (GELL)

ABSTRACT We aimed at investigating the prognostic role of the neutrophil-to-lymphocyte ratio (NLR) in two independent cohorts of Latin American patients with diffuse large B-cell lymphoma (DLBCL) treated with chemoimmunotherapy. The learning cohort was composed of 274, and the validation cohort of 323 patients, for a total of 597 patients. An optimal NLR cutoff ≥4 was determined using ROC analysis. In multivariate models, NLR ≥4 was independently associated with lower odds for complete response to chemoimmunotherapy in the learning (OR 0.46; p=0.006) and the validation cohort (OR 0.49; p=0.01), and independently associated with worse survival in the learning (HR 1.55; p=0.04) and the validation cohort (HR 1.80; p=0.003). The adverse prognostic value of NLR ≥4 was independent of the IPI and the NCCN-IPI score. Based on the results of this multi-institutional study, NLR ≥4 emerges as an adverse prognostic factor in Latin American patients with DLBCL treated with chemoimmunotherapy.