Ucar Mehmet Ali, Tombak Anıl, Akdeniz Aydın, Dinçyürek Hüseyin Derya, Şener Meryem, Koyuncu Mahmut Bakır, Tiftik Eyüp Naci, Dokuyucu Recep
Department of Hematology, Faculty of Medicine, Balcalı Hospital, Cukurova University, Adana 01330, Turkey.
Department of Internal Medicine, Division of Hematology, Faculty of Medicine, Mersin University, Mersin 33110, Turkey.
Medicina (Kaunas). 2025 May 30;61(6):1019. doi: 10.3390/medicina61061019.
this study aimed to evaluate the prognostic significance of systemic immune-inflammatory markers, particularly the pan-immune-inflammation value (PIV) and systemic immune-inflammation Index (SII), in predicting overall survival among patients with hematologic malignancies. This retrospective cohort study included 300 patients diagnosed with various hematologic malignancies between January 2020 and January 2025 at the Department of Hematology, Faculty of Medicine, Mersin University. Baseline laboratory data, including neutrophil, lymphocyte, platelet, and monocyte counts, were collected to calculate SII, NLR, PLR, and PIV. Patients were stratified into high and low groups based on the median values of these markers. Overall survival was analyzed using Kaplan-Meier curves and Cox proportional hazards models, adjusted for age, sex, malignancy type, and disease stage. High levels of PIV and SII were significantly associated with poorer overall survival. In univariate analysis, high PIV (HR: 2.35, 95% CI: 1.68-3.28, < 0.001) and high SII (HR: 2.12, 95% CI: 1.53-2.95, < 0.001) were strong predictors of mortality. After multivariate adjustment, PIV (adjusted HR: 2.14, 95% CI: 1.47-3.11, < 0.001) and SII (adjusted HR: 1.88, 95% CI: 1.32-2.67, = 0.001) remained independent prognostic factors. Subgroup analyses demonstrated that the predictive power of PIV and SII was consistent across different malignancy types, particularly in acute myeloid leukemia and multiple myeloma patients. Our findings indicated that systemic immune-inflammatory markers, particularly PIV and SII, are valuable prognostic tools in hematologic malignancies. These markers, derived from routine blood counts, offer a simple cost-effective means for improving risk stratification. Incorporating these indices into clinical practice could enhance individualized management strategies. Further prospective studies are warranted to validate these findings.
本研究旨在评估全身免疫炎症标志物,特别是全免疫炎症值(PIV)和全身免疫炎症指数(SII),在预测血液系统恶性肿瘤患者总生存方面的预后意义。这项回顾性队列研究纳入了2020年1月至2025年1月在梅尔辛大学医学院血液科诊断为各种血液系统恶性肿瘤的300例患者。收集包括中性粒细胞、淋巴细胞、血小板和单核细胞计数在内的基线实验室数据,以计算SII、NLR、PLR和PIV。根据这些标志物的中位数将患者分为高分组和低分组。使用Kaplan-Meier曲线和Cox比例风险模型分析总生存,并对年龄、性别、恶性肿瘤类型和疾病分期进行校正。高水平的PIV和SII与较差的总生存显著相关。在单因素分析中,高PIV(HR:2.35,95%CI:1.68-3.28,<0.001)和高SII(HR:2.12,95%CI:1.53-2.95,<0.001)是死亡的强预测因素。多因素校正后,PIV(校正HR:2.14,95%CI:1.47-3.11,<0.001)和SII(校正HR:1.88,95%CI:1.32-2.67,=0.001)仍然是独立的预后因素。亚组分析表明,PIV和SII的预测能力在不同恶性肿瘤类型中是一致的,特别是在急性髓系白血病和多发性骨髓瘤患者中。我们的研究结果表明,全身免疫炎症标志物,特别是PIV和SII,是血液系统恶性肿瘤中有价值的预后工具。这些标志物来源于常规血常规,提供了一种简单且具有成本效益的方法来改善风险分层。将这些指标纳入临床实践可以增强个体化管理策略。有必要进行进一步的前瞻性研究来验证这些发现。