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Elevated Neutrophil-to-Lymphocyte-ratio and Platelet-to-Lymphocyte Ratio in Myelofibrosis: Inflammatory Biomarkers or Representatives of Myeloproliferation Itself?

Background/Aim: We aimed to investigate clinical associations of inflammatory biomarkers neutrophil-tolymphocyte- ratio (NLR) and platelet-to-lymphocyte-ratio (PLR) in patients with myelofibrosis, myeloproliferative neoplasm with inflammatory background. Patients and Methods: We retrospectively analyzed a cohort of 102 myelofibrosis patients. NLR and PLR were assessed in addition to other diseasespecific parameters. Results: NLR and PLR were significantly higher in myelofibrosis than in healthy controls. Higher NLR was significantly associated with Janus-kinase-2 (JAK2)- mutation, wild-type-Calreticulin (CALR), older age and parameters reflecting increased proliferative potential of disease (higher leukocytes, higher hemoglobin, larger spleensize), whereas there was no significant association with C-reactive-protein (CRP). Higher PLR was significantly associated with absence of blast-phase-disease, absence of constitutional-symptoms, lower percentage-of- circulatoryblasts, smaller spleen-size and lower CRP. In the Coxregression- model, higher-NLR (HR=2.76 ; p=0.004), lower- PLR (HR=1.99 ; p=0.042) and Dynamic-International-

Philadelphia chromosome negative myeloproliferative neoplasm, primary myelofibrosis, secondary myelofibrosis, inflammatory biomarkers, survival

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