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Lymphocyte-to-Monocyte Ratio: Prognostic Marker in Bladder Cancer?

By: Lauren Harrison, MS
Posted: Tuesday, May 25, 2021

The lymphocyte-to-monocyte ratio in patients with non–muscle-invasive bladder cancer on Bacillus Calmette-Guérin (BCG) immunotherapy was predictive of disease progression, outperforming platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios, based on a retrospective study. Andrzej Paradysz, MD, of the Medical University of Silesia in Zabrze, Poland, and his colleagues published these findings in Frontiers in Oncology.

Researchers utilized data from 125 patients with non–muscle-invasive bladder cancer who received BCG immunotherapy. About half of these patients (n = 61) experienced progression to muscle-invasive disease or had a high-grade recurrence, whereas the rest (n = 64) did not experience such disease progression. Information regarding each patient’s blood cell count analysis was obtained from charts; neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio were calculated and compared between groups.

Four models were made based on logistic regression to assess patients’ risk of developing disease progression. The first model was based on patient stage, grade, gender, and smoking status; subsequent models (2–4) used the aforementioned clinical data plus one of the hematologic ratios. Models 2 to 4 were then compared with the baseline model.

All three of the measured ratios (neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio) were found to be independent prognostic markers of disease progression in multivariable analysis. The model utilizing clinical data and lymphocyte-to-monocyte ratio demonstrated the highest prognostic value (AUC = 0.756) compared with the models using neutrophil-to-lymphocyte ratio (AUC = 0.676) and platelet to lymphocyte ratio (AUC = 0.677). In addition, adding the lymphocyte-to-monocyte ratio to the baseline model increased the area under the curve from the baseline model by about 0.08.

When the lymphocyte-to-monocyte ratio increased by one, the odds of developing disease progression decreased 46%. The optimal cutoff point of the lymphocyte-to-monocyte ratio was 3.25.

Disclosure: The authors reported no conflicts of interest.



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