Association between lymphocyte-associated ratios, C-reactive protein and prognostic value in myelodysplastic syndromes

Purpose: This study was designed to investigate the relationship between peripheral blood inflammatory markers and prognosis in MDS patients.Methods: We conducted a study involving 183 MDS patients who were diagnosed at Taizhou Hospital of Zhejiang Province and Enze Hospital between January 2015 and December 2019. The end point of follow-up was September 2022. To minimize the impact of other confounding factors among the 110 included MDS patients, X-tile software was used to determine the optimal cutoff points for peripheral blood inflammation markers. Based on these cutoff points, the cohort of patients was divided into a high-risk group and a low-risk group. The OS in each group was analyzed by the Kaplan–Meier method, and univariate and multivariate Cox regression analyses were employed.Results: The MDS patients included 73 men and 37 women with a median age of 72 years (32–92 years). The median OS was 28 months (1–83 months), 17 patients (15.45%) experienced conversion to AML, and 94 patients (85.45%) died during the follow-up period. The optimal cutoff points were ALC (1.2 × 109/L), AMC (0 × 109/L), CRP (6.1 mg/L), MLR (0.125), NLR (2.25) and PLR (71.4). Patients in the ALC (≤1.2 × 109/L, P = 0.017), MLR (>0.125, P = 0.01), PLR (>71.43, P = 0.044), and CRP (>6.1 mg/L, P < 0.0001) groups had shorter overall survival. The MLR (>0.125, P = 0.011) and CRP (>6.1 mg/L, P = 0.017) levels were related to poor prognosis.Conclusions: Elevated MLR and CRP levels may be independent indicators of poor prognosis in newly diagnosed MDS patients.