Platelet-to-lymphocyte ratio can predict post-HSCT outcomes

Among patients undergoing allogeneic haematopoietic stem cell transplantation (HSCT), preoperative platelet-to-lymphocyte ratio (PLR) appears to hold good predictive value for outcomes, a recent study has found.

Researchers retrospectively assessed 214 patients (mean age 54.7 years, 57.5 percent men) with haematological conditions scheduled for their first allogeneic HSCT. All were followed for up to 1,500 days after the transplant.

Compared against healthy individuals, HSCT patients showed significantly lower levels of absolute lymphocyte, neutrophil, and platelet counts (p<0.0001) at baseline. No such effect was reported for PLR.

Overall, 130 patients died during follow-up, yielding a mortality rate of 60.7 percent. Relapse of the underlying disease was reported in 63 patients (29.4 percent), while 73 (34.1 percent) died in remission. Median survival was 543 days.

The overall survival was significantly higher in patients with PLR above the cutoff value of 133. This was true for 1-year (70.0 percent vs 47.6 percent; p=0.0005) and 2-year (57.9 percent vs 33.6 percent; p=0.0001) survival.

Multivariate analysis confirmed that PLR was a significant and independent predictor of overall survival (hazard ratio [HR], 0.56; p=0.009).

“Our study suggests that … pre-HSCT PLR could be used as pre-HSCT prognostic factor for patients who undergo allogeneic stem cell transplantation,” the researchers said.

“In the future, it seems to be beneficial to generate more specific data in general for different types of blood cancers and their specific therapy strategies, in order to gain more differentiated evidence for the predictive value of … PLR,” they added.