%0 Journal Article
%T Prognostic value of hemogram parameters in osteosarcoma: The French OS2006 experience.
%A Bastard P
%A Cozic N
%A Brion R
%A Gaspar N
%A Piperno-Neumann S
%A Cordero C
%A Leculée-Thébaud E
%A Gomez-Mascard A
%A Rédini F
%A Marchais A
%A Ikonomova R
%A Cleirec M
%A Laurence V
%A Rigaud C
%A Abbas R
%A Verrecchia F
%A Brugières L
%A Minard-Colin V
%J Pediatr Blood Cancer
%V 71
%N 7
%D 2024 Jul 28
%M 38679845
%F 3.838
%R 10.1002/pbc.31029
%X <B>BACKGROUND: </B>Previous studies have shown that neutrophil-to-lymphocyte (NLR) ratio at diagnosis and early lymphocytes recovery on doxorubicin-based chemotherapy, may impact the outcome in patients with osteosarcoma (OST). This study aimed to evaluate the prognostic value of hemogram parameters in patients with OST treated with high-dose methotrexate and etoposide/ifosfamide (M-EI) chemotherapy.<BR><B>METHODS: </B>We retrospectively analyzed the prognostic value of various hemogram parameters at diagnosis and during therapy in a large consecutive cohort of patients with OST included in the French OS2006 trial and treated with M-EI chemotherapy.<BR><B>RESULTS: </B>A total of 164 patients were analyzed. The median age was 14.7 years (interquartile range [IQR]: 11.7-17). Median follow-up was 5.6 years (IQR: 3.3-7.7 years). Three-year event-free survival (EFS) and overall survival (OS) were 71.5% (95% confidence interval [CI]: 64%-78%) and 86.4% (95% CI: 80%-91%), respectively. In univariate analysis, blood count parameters at diagnosis and early lymphocyte recovery at Day 14 were not found prognostic of survival outcomes. By contrast, an increase of NLR ratio at Day 1 of the first EI chemotherapy (NLR-W4) was associated with reduced OS in univariate (p = .0044) and multivariate analysis (hazards ratio [HR] = 1.3, 95% CI: 1.1-1.5; p = .002), although not with EFS. After adjustment on histological response and metastatic status, an increase of the ratio NLR-W4 of 1 was associated with an increased risk of death of 30%.<BR><B>CONCLUSIONS: </B>We identified NLR-W4 as a potential early biomarker for survival in patients with OST treated with M-EI chemotherapy. Further studies are required to confirm the prognostic value of NLR and better identify immune mechanisms involved in disease surveillance.