Zhou Dian, Chen Wei, Cheng Hai, Qiao Jian-Lin, Zhu Li-Li, Li Zhen-Yu, Xu Kai-Lin
Blood Diseases Institute, Xuzhou Medical University, Jiangsu, China; Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Jiangsu, China.
Blood Diseases Institute, Xuzhou Medical University, Jiangsu, China; Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Jiangsu, China; Key Laboratory of Bone Marrow Stem Cell, Xuzhou, Jiangsu, China.
Leuk Res. 2018 Jun;69:1-6. doi: 10.1016/j.leukres.2018.03.013. Epub 2018 Mar 27.
Essential thrombocythemia (ET) is an uncommon chronic myeloproliferative disorder with no cure. Patients with ET are at risk of different complications, and currently there are no optimal prognostic standards to predict severe post-diagnosis complications such as thrombosis and hemorrhage. In this study, we retrospectively analyzed the full set of clinical data from 150 Chinese patients with ET enrolled from 2013 to 2016. We discovered that neutrophil-to-lymphocyte ratio (NLR), along with other known clinical parameters such as age, leukocyte count, incidence of thrombotic events is higher in patients with JAK2 V617F mutation. NLR is also higher in patients at high-risk stratification of thrombosis. Multivariate analysis showed that age (P = 0.001, 95% CI 1.023-1.089) and JAK2 V617F mutation (P = 0.003, 95% CI 1.837-21.035) were independent factors for thrombotic events, while age (P = 0.005, 95% CI 1.019-1.111) was the only predictive factor for hemorrhagic events at diagnosis. For future thrombotic events, multivariate analysis revealed NLR as the best predictive parameter (P < 0.001, 95% CI 1.173-1.486) when compared with other clinical parameters such as age (P = 0.037, 95% CI 1.004-1.126), thrombosis at diagnosis (P = 0.036, 95% CI 1.077-9.099) and WBC count (P = 0.047, 95% CI 1.001-1.109). Further ROC curve and Kaplan Meier analysis validated NLR as better prognostic marker for future thrombotic events and thrombosis-free survival. In summary, our data suggest that NLR parameter may possess great prognostic significance for future thrombosis in ET patients.
原发性血小板增多症（ET）是一种无法治愈的罕见慢性骨髓增殖性疾病。ET患者有发生不同并发症的风险，目前尚无预测诊断后严重并发症（如血栓形成和出血）的最佳预后标准。在本研究中，我们回顾性分析了2013年至2016年纳入的150例中国ET患者的全套临床数据。我们发现，中性粒细胞与淋巴细胞比值（NLR）以及其他已知临床参数（如年龄、白细胞计数、血栓形成事件发生率）在JAK2 V617F突变患者中更高。在血栓形成高危分层的患者中NLR也更高。多变量分析显示，年龄（P = 0.001，95% CI 1.023 - 1.089）和JAK2 V617F突变（P = 0.003，95% CI 1.837 - 21.035）是血栓形成事件的独立因素，而年龄（P = 0.005，95% CI 1.019 - 1.111）是诊断时出血事件的唯一预测因素。对于未来的血栓形成事件，多变量分析显示，与年龄（P = 0.037，95% CI 1.004 - 1.126）、诊断时的血栓形成（P = 0.036，95% CI 1.077 - 9.099）和白细胞计数（P = 0.047，95% CI 1.001 - 1.109）等其他临床参数相比，NLR是最佳预测参数（P < 0.001，95% CI 1.173 - 1.486）。进一步的ROC曲线和Kaplan Meier分析验证了NLR是未来血栓形成事件和无血栓生存期更好的预后标志物。总之，我们的数据表明，NLR参数可能对ET患者未来的血栓形成具有重要的预后意义。
