Lymphocyte-monocyte index as a new marker for the prognosis of early recurrence of the disease in patients with glioblastoma

Abstract

Every day, the number of scientific studies in the global medical community is growing, emphasizing the importance of the immune system in the prognosis and course of oncological diseases. The lymphocyte-monocyte index has already demonstrated its prognostic role in some forms of tumor disease. However, its significance in glioblastomas has not been fully determined.The aim of the study is to study the prognostic value of the lymphocyte-monocyte index for patients with glioblastoma.Material and methods. The study included 45 patients with primary supratentorial glioblastoma over the age of 18 who had reached the first relapse of the disease. In each case, the level of leukocytes, lymphocytes, monocytes and LMR (ratio of lymphocytes to monocytes) in peripheral blood before surgery was assessed, and symptomatic treatment with glucocorticosteroids was taken into account. The histological diagnosis was established in accordance with the WHO classification of Central nervous system tumors in 2021. All patients after the neurosurgical stage of treatment received standard antitumor treatment (radiation therapy, chemotherapy with temozolomide). The effect of LMR on the median of the first relapse-free period was studied.Results. A significant increase in the absolute number of monocytes was found in patients receiving dexamethasone therapy (p = 0.014). At the same time, the appointment of GCS did not affect the level of lymphocytes and LMR. The median of the first relapse-free period was statistically higher in patients with an LMR of more than 4 (p = 0.05; 47 vs 30.5 weeks).Conclusions. Low LMR is a marker of the prognosis of early recurrence of the disease for patients with glioblastomas. It is important to note that despite the fact that the level of monocytes was directly correlated with the appointment of glucocorticosteroids to patients, the LMR was not affected by the appointment of this group of drugs.