Resumen en Español :

Objetivos: Evaluar el valor pronóstico del índice neutrófilos/linfocitos (INL) en pacientes con Linfoma no Hodgkin (LNH). Materiales y métodos: Estudio retrospectivo, descriptivo,
observacional y comparativo utilizando el INL como inflamatorio al momento del diagnóstico de LNH. Se incluyó pacientes atendidos en los Servicio de Clínica Médica y Hematología, Hospital Lagomaggiore. Periodo: 2002-2023. INL= recuento absoluto neutrófilos/linfocitos.
Criterios de exclusión: pacientes con datos incompletos. El valor de corte óptimo del INL se estableció a través de Curvas de características operativas del receptor (ROC). Se comparó Grupo A (INL≥3.68) vs Grupo B (INL<3.67). Se definió mal pronóstico (MP): óbito, abandono de tratamiento.
Análisis estadístico: MedCalc: medidas de tendencia central, dispersión, análisis univariado mediante chi2 o test de Student, criterio de significación error α<5%, curvas de supervivencia por método Log Rank y curvas Kaplan Meier. Resultados: Se incluyeron 44 pacientes. Varones 23 (52.2%). LNH más frecuente células precursoras B 39 (88.6%), subtipo difuso de células grandes B (LDCGB): 17 (43.6%), Tratamiento: 39 (92.8%). INL: 3.7 ±4.2. Área bajo la curva (ABC) ROC para INL 0.49 (0.32- 0.65); punto de corte ≥3.68, sensibilidad 32% (14.9-53.5), especificidad 84.6% (54.6-98.1), LHR+ 2.08, LHR- 0.8. Análisis comparativo: Grupo A 13 (29.55%). Fueron mujeres 7 (53.85%) vs 14 (45.2%) p0.6. Edad 43.7 ±16 vs 58.3 ±12.4 años p0.002, mayores de 60 años 2 (15.4%) vs 18 (58.1%) p0.009. Comórbidas 2 (15.4%) vs 14 (45.2%) p0.06. Síntomas B 5 (38.5%) vs 9 (29%)
p0.5. LDH elevada 10 (90.9%) vs 21 (95.45%) p0.6. Estadio avanzado (III-IV) 9 (69.2%) vs 21 (67.7%) p0.9. Compromiso nodal 11 (84.6%) vs 29 (93.55%) p0.3. Compromiso extranodal 9 (69.2%) vs 12 (41.4%) p0.05. Intercurrencia infecciosa 5 (45.45%) vs 12 (40%) p0.75. Remisión completa 3 (30%) vs 7 (25.9%) p0.8. Mortalidad a los 5 años 8 (61.5%) vs 16 (51.6.%) p 0.28, HR 1.54 (0.61- 3.89). Mortalidad global 25 (65.8%): 8 (72.7%) vs 17 (63%) p0.5. Conclusión: Los pacientes con LNH y mayor INL fueron mujeres con una edad media
al momento del diagnóstico significativamente menor y mayor compromiso extranodal. La mortalidad fue del 65%, siendo mayor en pacientes con mayor INL sin diferencias significativas.

Resumen en Inglés :

Objectives: To evaluate the prognostic value of the neutrophil/lymphocyte ratio (NLR) in patients with non-Hodgkin lymphoma (NHL). Materials and methods: Retrospective, descriptive, observational and comparative study using the NLR as an inflammatory at the time of NHL diagnosis. It includes patients treated at the Medical Clinic and Hematology Service, Lagomaggiore Hospital. Period: 2002-2023. INL =
absolute neutrophil/lymphocyte count. Exclusion criteria: patients with incomplete data. The optimal cut-off value of INL was developed through Receiver Operating Characteristics (ROC) Curves. Group A (INL≥3.68) was compared with Group B (INL<3.67). Poor prognosis (MP) was defined: death, treatment abandonment.
Statistical analysis: MedCalc: measures of central tendency, dispersion, univariate analysis using chi2 or Student's test, significance criterion error α<5%, survival curves by Log Rank method and Kaplan Meier curves. Results: 44 patients were included. Men 23 (52.2%). NHL most common precursor B cells 39 (88.6%), diffuse large B cell subtype (DLBCL): 17 (43.6%), Treatment: 39 (92.8%). INL: 3.7 ±4.2. Area under the curve (AUC) ROC for INL 0.49 (0.32-0.65); cutoff point ≥3.68, sensitivity 32% (14.9-53.5), specificity 84.6% (54.6-98.1), LHR+ 2.08, LHR- 0.8. Comparative analysis: Group A 13 (29.55%). There were 7 (53.85%) women vs 14 (45.2%) p0.6. Age 43.7 ±16 vs 58.3 ±12.4 years p0.002, over 60 years 2 (15.4%) vs 18 (58.1%) p0.009. Comorbidities 2 (15.4%) vs 14 (45.2%) p0.06. Symptoms B 5 (38.5%) vs 9 (29%) p0.5. LDH increased 10 (90.9%) vs 21 (95.45%) p0.6. Advanced stage (III-IV) 9 (69.2%) vs 21 (67.7%)
p0.9. Nodal commitment 11 (84.6%) vs 29 (93.55%) p0.3. Extranodal involvement 9 (69.2%) vs 12 (41.4%) p0.05. Infectious occurrence 5 (45.45%) vs 12 (40%) p0.75. Complete remission 3 (30%) vs 7 (25.9%) p0.8. Mortality at 5 years 8 (61.5%) vs 16 (51.6.%) p 0.28, HR 1.54 (0.61- 3.89). Overall mortality 25 (65.8%): 8 (72.7%) vs 17 (63%) p0.5. Conclusion: Patients with NHL and higher NLR were women with a significantly
lower mean age at diagnosis and greater extranodal involvement. Mortality was 65%, being higher in patients with higher NLR without significant differences.

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