TY - JOUR
T1 - Neutrophil-to-lymphocyte ratio is a novel predictor of venous thrombosis in polycythemia vera
AU - Carobbio, Alessandra
AU - Vannucchi, Alessandro Maria
AU - De Stefano, Valerio
AU - Masciulli, Arianna
AU - Guglielmelli, Paola
AU - Loscocco, Giuseppe Gaetano
AU - Ramundo, Francesco
AU - Rossi, Elena
AU - Kanthi, Yogendra
AU - Tefferi, Ayalew
AU - Barbui, Tiziano
N1 - Funding Information:
The study was supported by European LeukemiaNet (ELN) (TB), by AIRC 5 × 1000 call “Metastatic disease: the key unmet need in oncology” to MYNERVA project #21267 (MYeloid NEoplasms Research Venture AIRC) (AMV), and by funding support from the Intramural Research Program of the NHLBI/NIH and Lasker Foundation (YK).
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/2
Y1 - 2022/2
N2 - We investigated the neutrophil-to-lymphocyte ratio (NLR) as a predictor of thrombosis in polycythemia vera (PV). After a median follow-up of 2.51 years, of 1508 PV patients enrolled in the ECLAP study, 82 and 84 developed arterial and venous thrombosis, respectively. Absolute counts of total leukocytes, neutrophils, lymphocytes, platelets, and the NLR were tested by generalized additive models (GAM) to evaluate their trend in continuous scale of thrombotic risk. Only for venous thrombosis, we showed that baseline absolute neutrophil and lymphocyte counts were on average respectively higher (median: 6.8 × 109/L, p = 0.002) and lower (median: 1.4 × 109/L, p = 0.001), leading to increased NLR values (median: 5.1, p = 0.002). In multivariate analysis, the risk of venous thrombosis was independently associated with previous venous events (HR = 5.48, p ≤ 0.001) and NLR values ≥5 (HR = 2.13, p = 0.001). Moreover, the relative risk in both low- and high-standard risk groups was almost doubled in the presence of NLR ≥ 5. These findings were validated in two Italian independent external cohorts (Florence, n = 282 and Rome, n = 175) of contemporary PV patients. Our data support recent experimental work that venous thrombosis is controlled by innate immune cells and highlight that NLR is an inexpensive and easily accessible prognostic biomarker of venous thrombosis.
AB - We investigated the neutrophil-to-lymphocyte ratio (NLR) as a predictor of thrombosis in polycythemia vera (PV). After a median follow-up of 2.51 years, of 1508 PV patients enrolled in the ECLAP study, 82 and 84 developed arterial and venous thrombosis, respectively. Absolute counts of total leukocytes, neutrophils, lymphocytes, platelets, and the NLR were tested by generalized additive models (GAM) to evaluate their trend in continuous scale of thrombotic risk. Only for venous thrombosis, we showed that baseline absolute neutrophil and lymphocyte counts were on average respectively higher (median: 6.8 × 109/L, p = 0.002) and lower (median: 1.4 × 109/L, p = 0.001), leading to increased NLR values (median: 5.1, p = 0.002). In multivariate analysis, the risk of venous thrombosis was independently associated with previous venous events (HR = 5.48, p ≤ 0.001) and NLR values ≥5 (HR = 2.13, p = 0.001). Moreover, the relative risk in both low- and high-standard risk groups was almost doubled in the presence of NLR ≥ 5. These findings were validated in two Italian independent external cohorts (Florence, n = 282 and Rome, n = 175) of contemporary PV patients. Our data support recent experimental work that venous thrombosis is controlled by innate immune cells and highlight that NLR is an inexpensive and easily accessible prognostic biomarker of venous thrombosis.
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U2 - 10.1038/s41408-022-00625-5
DO - 10.1038/s41408-022-00625-5
M3 - Article
C2 - 35145055
AN - SCOPUS:85124447850
SN - 2044-5385
VL - 12
JO - Blood Cancer Journal
JF - Blood Cancer Journal
IS - 2
M1 - 28
ER -