High mean platelet volume and neutrophil-to-lymphocyte ratio are predictors of mortality in patients with HIV-related non-Hodgkin's lymphoma

Abstract

Introduction: Simple indices derived from a blood count are useful as predictors of survival in both solid and hematological tumors. However, these indices have not been studied in human immunodeficiency virus (HIV)-associated non-Hodgkin's lymphoma (NHL). The present study evaluates whether there are differences in the survival of such patients at two years according to baseline values of mean platelet volume (MPV) and neutrophil-to-lymphocyte ratio (NLR). Material and methods: A retrospective cohort of patients between 2003 and 2018 with HIV and a confirmed diagnosis of some variant of nNHL at the Hospital Universitario San Ignacio, Bogotá, Colombia, was evaluated. 2-year survival was analyzed by comparing groups according to baseline values of MPV and NLR using Kaplan-Meier curves and log rank test. Cox regression model was used to control for confounding factors. Results: 31 patients were included. The combined follow-up time was 602 months. Ten patients died during follow-up. The 2-year survival was lower for patients with MPV >7.5 fL (41.6 vs. 84.0%, p =0.01, log rank test: 0.0057) and NLR >4.35 (33.0% vs. 76.0%, p =0.04; log rank test 0.028). Mortality was higher in patients with MPV >7.5 fL (HR 6.39; confidence interval 95% 1.35-30.21, p =0.015) controlling by the effect of type of lymphoma, International Prognostic Index and functionality. Conclusion: High values of MPV and NLR at the time of diagnosis of NHL are associated with mortality in patients with HIV infection. It is necessary to evaluate the utility of including these markers in prognostic indices.