Prospective Trial of Neutrophil/Lymphocyte Ratio and Other Blood Counts as Biomarkers of Survival among Patients with High-Grade Soft Tissue Sarcomas Treated with Pegylated Liposomal Doxorubicin and Ifosfamide

Simple Summary Previous studies have reported an association between the ratio of neutrophils to lymphocytes circulating in blood and outcomes in patients with cancer. This study examined the association between lymphocyte and neutrophil counts and survival in a prospective trial of preoperative chemotherapy for high-grade soft-tissue sarcomas. A statistically significant association between overall survival was observed with the neutrophil/lymphocyte ratio. Our results suggest that a balance between the lymphocyte count and the number of circulating myeloid cells that might suppress lymphocyte function may be predictive of survival in patients with soft-tissue sarcomas. Future research should examine the role of lymphocyte-myeloid cell balance in sarcoma biology. Several studies have reported an association between levels of circulating blood cells, in particular the neutrophil to lymphocyte ratio (absolute neutrophil count (ANC)/absolute lymphocyte count (ALC)) and outcomes in patients with cancer. In the current study, the association between lymphocyte, neutrophil, monocyte, and platelet counts and survival was examined in a prospective trial of preoperative pegylated-liposomal doxorubicin and ifosfamide for high-grade soft-tissue sarcomas. A statistically significant association between overall survival, but not progression free-survival, was observed with the ANC/ALC ratio at a cutoff value of >= 2 and a statistically significant trend using a cutoff of >= 5. Our results suggest that a balance between the lymphocyte count and the number of circulating myeloid cells that can suppress lymphocyte function may be predictive of survival in patients with soft-tissue sarcomas. Future research should therefore examine the role of lymphocyte-myeloid cell balance in sarcoma biology.