Hematology, Department of Translational and Precision Medicine, Policlinico Umberto I-Sapienza University, Rome, Italy.
Hematology Unit, Businco Hospital, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
Eur J Haematol. 2024 Jun;112(6):938-943. doi: 10.1111/ejh.14188. Epub 2024 Feb 9.
Myelofibrosis (MF) is a clonal Philadelphia chromosome negative myeloproliferative neoplasm (Ph-MPN). MF is featured by an inflammatory condition that can also drive the progression of disease. Ruxolitinib (ruxo) is the-first-in-class Jak1/2 inhibitor approved for treatment of MF, proved to reduce spleen volume and decrease symptom burden. In various malignancies neutrophil-to-lymphocyte ratio (NLR) has been indicated as predictor of progression free survival (PFS) and overall survival (OS). NLR might reflect the balance between systemic inflammation and immunity and is emerging as a prognostic biomarker in several neoplasms, including the hematological ones.
We analyzed a cohort of 140 MF patients treated with ruxo to validate baseline NLR (as a continuous variable and as a cut-off 2) as predictor of OS and of ruxo treatment discontinuation.
We found that both baseline NLR as a continuous variable [HR 0.8 (95% CI: 0.7-0.9) (p = .006)] and NLR (<2 vs. ≥2) [HR 3.4 (95% CI: 1.6-7.0) (p = .001)] were significantly associated with OS. Censoring for patients undergone allotransplant, baseline NLR <2 was predictive of an earlier ruxo any-other-cause discontinuation [HR 3.7 (95%CI 1.7-8.3) (p < .001)].
NLR before starting ruxo treatment may be used as a simple and early predictor of OS and earlier ruxo discontinuation in clinical practice.
骨髓纤维化（MF）是一种费城染色体阴性的克隆性骨髓增殖性肿瘤（Ph-MPN）。MF 的特征是一种炎症状态，也可以驱动疾病的进展。芦可替尼（ruxo）是首个被批准用于治疗 MF 的 Jak1/2 抑制剂，已被证明可减少脾脏体积并降低症状负担。在各种恶性肿瘤中，中性粒细胞与淋巴细胞比值（NLR）已被证明是无进展生存期（PFS）和总生存期（OS）的预测因子。NLR 可能反映了全身炎症和免疫之间的平衡，并且作为预后生物标志物在包括血液系统恶性肿瘤在内的多种肿瘤中逐渐显现。
我们分析了 140 例接受芦可替尼治疗的 MF 患者的队列，以验证基线 NLR（作为连续变量和截距 2）作为 OS 和芦可替尼治疗停药的预测因子。
我们发现，基线 NLR 作为连续变量[风险比 0.8（95%置信区间：0.7-0.9）（p=0.006）]和 NLR（<2 与≥2）[风险比 3.4（95%置信区间：1.6-7.0）（p=0.001）]均与 OS 显著相关。对接受同种异体移植的患者进行 censoring 后，基线 NLR<2 与芦可替尼因任何其他原因停药更早相关[风险比 3.7（95%CI 1.7-8.3）（p<0.001）]。
芦可替尼治疗前的 NLR 可作为 OS 和更早芦可替尼停药的简单且早期预测因子，用于临床实践中。
