Neutrophil-to-lymphocyte ratio and all-cause mortality with and without myeloproliferative neoplasms—a Danish longitudinal study
Abstract The neutrophil-to-lymphocyte ratio(NLR) is increased in chronic inflammation and myeloproliferative neoplasms (MPN). We hypothesize that NLR is associated with all-cause mortality and mortality by comorbidity burden in the general population and individuals with MPN. We included 835,430 ind...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Nature Publishing Group
2024-02-01
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| Series: | Blood Cancer Journal |
| Online Access: | https://doi.org/10.1038/s41408-024-00994-z |
| _version_ | 1797275841375240192 |
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| author | Morten Kranker Larsen Vibe Skov Lasse Kjær Christina Schjellerup Eickhardt-Dalbøge Trine Alma Knudsen Marie Hvelplund Kristiansen Anders Lindholm Sørensen Troels Wienecke Morten Andersen Johnny T. Ottesen Johanne Gudmand-Høyer Jordan Andrew Snyder Mikkel Porsborg Andersen Christian Torp-Pedersen Henrik Enghusen Poulsen Thomas Stiehl Hans Carl Hasselbalch Christina Ellervik |
| author_facet | Morten Kranker Larsen Vibe Skov Lasse Kjær Christina Schjellerup Eickhardt-Dalbøge Trine Alma Knudsen Marie Hvelplund Kristiansen Anders Lindholm Sørensen Troels Wienecke Morten Andersen Johnny T. Ottesen Johanne Gudmand-Høyer Jordan Andrew Snyder Mikkel Porsborg Andersen Christian Torp-Pedersen Henrik Enghusen Poulsen Thomas Stiehl Hans Carl Hasselbalch Christina Ellervik |
| author_sort | Morten Kranker Larsen |
| collection | DOAJ |
| description | Abstract The neutrophil-to-lymphocyte ratio(NLR) is increased in chronic inflammation and myeloproliferative neoplasms (MPN). We hypothesize that NLR is associated with all-cause mortality and mortality by comorbidity burden in the general population and individuals with MPN. We included 835,430 individuals from The Danish General Suburban Population Study, general practitioners, and outpatient clinics. We investigated NLR on mortality stratified by prevalent and incident MPN, essential thrombocythemia (ET), polycythemia vera (PV), myelofibrosis (MF), comorbidity burden (CCI-score), and the Triple-A risk score using hazard ratio (HR) and 95% confidence interval (95%CI). NLR 1–1.9 was the reference level. During a median follow-up of 11.2 years, 197,802 deaths were recorded. All-cause mortality increased for a stepwise increasing NLR with a HR (95%CI) for NLR ≥ 6 of 2.06(2.03–2.09) for the whole population and 2.93(2.44–3.50) in prevalent MPN. ET, PV, and MF had a HR (95%CI) for NLR ≥ 2 of 2.14(1.71–2.69), 2.19(1.89–2.54), and 2.31(1.91–2.80). Results were similar for incident MPN. Mortality was higher for stepwise increasing NLR and CCI-score(p interaction < 2×10–16), with a HR for NLR ≥ 6 of 2.23(2.17–2.29), 4.10(4.01–4.20), and 7.69(7.50–7.89), for CCI-score 0, 1–2, or ≥3. The Triple-A risk score demonstrated alignment with NLR. Increasing NLR and comorbidity burden were associated with lower survival in individuals without MPN but were even worse in prevalent and incident MPN, ET, PV, and MF. |
| first_indexed | 2024-03-07T15:18:51Z |
| format | Article |
| id | doaj.art-46ca4a43de774498aff8a1da1a776787 |
| institution | Directory Open Access Journal |
| issn | 2044-5385 |
| language | English |
| last_indexed | 2024-03-07T15:18:51Z |
| publishDate | 2024-02-01 |
| publisher | Nature Publishing Group |
| record_format | Article |
| series | Blood Cancer Journal |
| spelling | doaj.art-46ca4a43de774498aff8a1da1a7767872024-03-05T17:44:24ZengNature Publishing GroupBlood Cancer Journal2044-53852024-02-0114111210.1038/s41408-024-00994-zNeutrophil-to-lymphocyte ratio and all-cause mortality with and without myeloproliferative neoplasms—a Danish longitudinal studyMorten Kranker Larsen0Vibe Skov1Lasse Kjær2Christina Schjellerup Eickhardt-Dalbøge3Trine Alma Knudsen4Marie Hvelplund Kristiansen5Anders Lindholm Sørensen6Troels Wienecke7Morten Andersen8Johnny T. Ottesen9Johanne Gudmand-Høyer10Jordan Andrew Snyder11Mikkel Porsborg Andersen12Christian Torp-Pedersen13Henrik Enghusen Poulsen14Thomas Stiehl15Hans Carl Hasselbalch16Christina Ellervik17Department of Hematology, Zealand University HospitalDepartment of Hematology, Zealand University HospitalDepartment of Hematology, Zealand University HospitalDepartment of Hematology, Zealand University HospitalDepartment of Hematology, Zealand University HospitalDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of CopenhagenDepartment of Hematology, Zealand University HospitalDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of CopenhagenDepartment of Science and Environment, Roskilde UniversityDepartment of Science and Environment, Roskilde UniversityDepartment of Science and Environment, Roskilde UniversityDepartment of Science and Environment, Roskilde UniversityDepartment of Cardiology, Copenhagen University Hospital, Nordsjællands HospitalDepartment of Cardiology, Copenhagen University Hospital, Nordsjællands HospitalDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of CopenhagenDepartment of Science and Environment, Roskilde UniversityDepartment of Hematology, Zealand University HospitalDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of CopenhagenAbstract The neutrophil-to-lymphocyte ratio(NLR) is increased in chronic inflammation and myeloproliferative neoplasms (MPN). We hypothesize that NLR is associated with all-cause mortality and mortality by comorbidity burden in the general population and individuals with MPN. We included 835,430 individuals from The Danish General Suburban Population Study, general practitioners, and outpatient clinics. We investigated NLR on mortality stratified by prevalent and incident MPN, essential thrombocythemia (ET), polycythemia vera (PV), myelofibrosis (MF), comorbidity burden (CCI-score), and the Triple-A risk score using hazard ratio (HR) and 95% confidence interval (95%CI). NLR 1–1.9 was the reference level. During a median follow-up of 11.2 years, 197,802 deaths were recorded. All-cause mortality increased for a stepwise increasing NLR with a HR (95%CI) for NLR ≥ 6 of 2.06(2.03–2.09) for the whole population and 2.93(2.44–3.50) in prevalent MPN. ET, PV, and MF had a HR (95%CI) for NLR ≥ 2 of 2.14(1.71–2.69), 2.19(1.89–2.54), and 2.31(1.91–2.80). Results were similar for incident MPN. Mortality was higher for stepwise increasing NLR and CCI-score(p interaction < 2×10–16), with a HR for NLR ≥ 6 of 2.23(2.17–2.29), 4.10(4.01–4.20), and 7.69(7.50–7.89), for CCI-score 0, 1–2, or ≥3. The Triple-A risk score demonstrated alignment with NLR. Increasing NLR and comorbidity burden were associated with lower survival in individuals without MPN but were even worse in prevalent and incident MPN, ET, PV, and MF.https://doi.org/10.1038/s41408-024-00994-z |
| spellingShingle | Morten Kranker Larsen Vibe Skov Lasse Kjær Christina Schjellerup Eickhardt-Dalbøge Trine Alma Knudsen Marie Hvelplund Kristiansen Anders Lindholm Sørensen Troels Wienecke Morten Andersen Johnny T. Ottesen Johanne Gudmand-Høyer Jordan Andrew Snyder Mikkel Porsborg Andersen Christian Torp-Pedersen Henrik Enghusen Poulsen Thomas Stiehl Hans Carl Hasselbalch Christina Ellervik Neutrophil-to-lymphocyte ratio and all-cause mortality with and without myeloproliferative neoplasms—a Danish longitudinal study Blood Cancer Journal |
| title | Neutrophil-to-lymphocyte ratio and all-cause mortality with and without myeloproliferative neoplasms—a Danish longitudinal study |
| title_full | Neutrophil-to-lymphocyte ratio and all-cause mortality with and without myeloproliferative neoplasms—a Danish longitudinal study |
| title_fullStr | Neutrophil-to-lymphocyte ratio and all-cause mortality with and without myeloproliferative neoplasms—a Danish longitudinal study |
| title_full_unstemmed | Neutrophil-to-lymphocyte ratio and all-cause mortality with and without myeloproliferative neoplasms—a Danish longitudinal study |
| title_short | Neutrophil-to-lymphocyte ratio and all-cause mortality with and without myeloproliferative neoplasms—a Danish longitudinal study |
| title_sort | neutrophil to lymphocyte ratio and all cause mortality with and without myeloproliferative neoplasms a danish longitudinal study |
| url | https://doi.org/10.1038/s41408-024-00994-z |
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