Prognostic Evaluation of Neutrophil/Lymphocyte Ratio in Patients with Mycosis Fungoides

Background: The role of inflammation has been established in cancer biology and the neutrophil to lymphocyte ratio postulated as a marker of systemic inflammatory response. The prognostic significance of neutrophil to lymphocyte ratio has never been explored in patients with mycosis fungoides.

Methods: Data from 119 mycosis fungoides (MF) patients, diagnosed between 1998 and 2015 at a single centre, were evaluated retrospectively. The prognostic influence of the neutrophil to lymphocyte ratio and other clinico-pathological factors including age, lactate dehydrogenase, stage of disease, beta-2-microglobulin levels, and total IgE levels were evaluated.

Results: The mean value of absolute neutrophil count and absolute lymphocyte count (ANC/ALC) ratio was 2.07±1.17 in the patient group, whereas it was 1.76±0.53 in the control group (<0.05). An ANC/ALC value of 2.85 corresponded to the maximum combined sensitivity and specificity on the ROC curve. ANC/ALC ratios of 2.85 or higher at diagnosis were positively correlated with elevated Beta-2-microglobulin (=0.026), advanced disease stage, and disease progression (=0.026, r=0.204) (=0 .006, r=0.251) (=0 .018, r=0.216).

Conclusion: In the present study, we showed that a high ANC/ALC ratio at diagnosis of MF represents a simple, poor prognostic factor for identifying high-risk patients with MF.