Correlation of neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR) with r-chop therapy response in diffuse large B-cell lymphoma (DLBCL) patients

Background: The exploration of simple, cost-effective, and low-risk prognostic markers, such as the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) as predictive factors for survival in diffuse large B-cell lymphoma (DLBCL) patients receiving R-CHOP therapy has become increasingly important due to the variability in results seen in prior studies. Methods: This observational cross-sectional study analyzed NLR, LMR, and PLR as predictors of survival in DLBCL patients treated with R-CHOP. Data was collected from DLBCL patients from June 2017 to June 2022. All statistical analyses were performed using R version 4.2.3 using pROC package for receiver-operating characteristic curves analyses. Univariate and multivariate logistic regression analyses were performed to assess predictors’ association with overall survival (OS). Results: There were 112 DLBCL patients receiving R-CHOP, 87 were classified as surviving, while 25 were not. Univariate logistic regression analyses revealed significant associations between overall survival (OS) and IPI scores (p < 0.001). Conversely, gender, response to R-CHOP therapy, and hematologic indicators of NLR > 2.0, PLR > 213.4, and LMR > 1.1 did not show significant associations with OS. Multivariable logistic regression analysis using backward selection identified LMR (p = 0.036; 0.24 (95%CI: 0.05 to 0.84) as independent predictors for OS in DLBCL patients. Conclusions: Our study revealed several fundamental risk factors, including extranodal involvement, ECOG performance status, LDH, and LMR, were independently associated with 2-year mortality in DLBCL patients before initiating R-CHOP therapy. However, due to the limitations of this study, further research with larger sample sizes is warranted.