Objective: The neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) as inflammatory biomarkers have emerged as prognostic factors for patients with cancer. We aimed to explore the association between the NLR/PLR and prognosis in diffuse large B-cell lymphoma (DLBCL).

Methodology: The study was carried out retrospectively. A systematic search of the hospital database regarding DLBCL patients was performed between April 2004 and March 2019. Completely accessible data were included in the study.

Results: Overall, 122 patients included in the study. There were 64 males and 58 females. At the time of diagnosis, the mean age was 51.3±14.3 years, whereas 26 (21.3%) were under 40 years, 26 (21.3%) between 40–49 years, 35 (28.7%) between 50-59 years, and 35 (28.7%) were over 60 years old. Approximately 50% were at an advanced stage. At the time of diagnosis, the mean NLR was 3.8 with an absolute neutrophil count of 4852.4/μL (0.600–16.000/μL), and the absolute lymphocyte count of 1757.9/μL (0.100–15.000/μL). The mean PLR was 213.6, with a mean platelet count of 250,000/μL (range 260,000–715,000/μL). ROC analysis gave the cut-off point for PLR as >152.86, and NLR >3.05. All patients (90.2%) received R-CHOP based therapy. The median follow-up time was 69 months (range 3–244). During the follow-up period, 8.2% of patients died. Patients with high NLR levels showed more frequent B symptoms (p=0.034). Patients with high PLR levels had a statistically significant lower overall survival (OS) and progression-free survival (PFS) (p=0.012 and p=0.004, respectively). In patients with high NLR levels, the OS rate proved to be shorter, but this finding has not achieved a statistical significance. However, PFS was statistically significantly shorter (p=0.022). In the multivariate analysis of PLR and clinical factors in terms of non-progressive survival, age, IPI score, and high PLR level are independent risk factors for non-progressive survival (p=0.013, p=0.039 and p=0.031, respectively). In multivariate analysis of NLR and clinical factors, age and IPI score are independent risk factors for non-progressive survival (p=0.026 and p=0.046, respectively).

Conclusion: This study demonstrated that elevated pre-treatment PLR was significantly associated with poor prognosis in DLBCL patients. PLR could be helpful as a potential prognostic biomarker to guide clinical decision-making and select individualized treatment strategies for DLBCL patients.