الفهرس 
Aim of the workOnly 14 pages are availabe for public view
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Abstract
The aim of this work was to determine the prognostic effect of pretreatment base line absolute neutrophil count to lymphocyte count ratio (ANC/ALC ratio) in lymphoma patients as regard overall survival.
Receiver operating characteristics (ROC Curve) of ANC/ ALC ratio according to response to treatment was generated to determine the cut off value for ANC/ ALC ratio, the area under the curve was recorded as (AUC=0.821), ANC/ ALC ratio cut off value of 2.09 corresponded to the maximum combined sensitivity (93.75%) and specificity (86.73%) on the ROC curve, ANC/ALC ratio<2.09 low ratio, ANC/ALC>2.09 high ratio.
The NLR was determined by dividing the peripheral blood levels of ANC by ALC at diagnosis. Previous research found that lymphopenia was related to adverse prognosis.
All patients subjected to full history taking, clinical examination, laboratory investigation (as complete blood picture, liver & kidney function tests, LDH, ESR, B2M & ALP), excisional biopsy of enlarged lymph node, bone marrow examination & ratio of neutrophil to lymphocyte. In our study, the optimal cut-off value for NLR was 2.09. malignant lymphoma patients with NLR >2.09 had a shorter over-all survival rate compared to those with NLR <2.09. However, NLR was found to have no significant association with age, sex or presence of B-symptom.
Our conclusion is that the ANC/ ALC ratio can be used to determine prognosis in lymphoma as it was a strong and independent prognostic parameter in both type of lymphoma, inexpensive to perform, and simple to apply. This supports the possibility that host immunity (ie, lymphocytes) and inflammatory responses (ie, neutrophils) have prognostic relevance for clinical outcomes.