Validation of the pretreatment derived neutrophil-lymphocyte ratio as a prognostic factor in a European cohort of patients with upper tract urothelial carcinoma.

BACKGROUND: The value of a combined index of neutrophil and white cell counts, named derived neutrophil-lymphocyte ratio (dNLR), has recently been proposed as a prognosticator of survival in various cancer types. We investigated the prognostic role of the dNLR in a large European cohort of patients with upper tract urothelial carcinoma (UTUC). METHODS: Data from 171 non-metastatic UTUC patients, operated between 1990 and 2012 at a single tertiary academic centre, were evaluated retrospectively. Cancer-specific- (CSS) as well as overall survival (OS) were assessed using the Kaplan-Meier method. To evaluate the independent prognostic significance of the dNLR, multivariate proportional Cox-regression models were applied. Additionally, the influence of the dNLR on the predictive accuracy of the multivariate model was further determined by Harrell's concordance index (c-index). RESULTS: The median follow-up period was 31 months. An increased dNLR was statistically significantly associated with shorter CSS (log-rank P=0.004), as well as with shorter OS (log-rank P=0.002). Multivariate analysis identified dNLR as an independent predictor for CSS (hazard ratio, HR=1.16, 95% confidence interval, CI=1.01-1.35, P=0.045), as well as for OS (HR=1.21, 95% CI=1.09-1.34, P<0.001). The estimated c-index of the multivariate model for OS was 0.68 without dNLR and 0.73 when dNLR was added. CONCLUSIONS: Patients with a high pretreatment dNLR could be predicted to show subsequently higher cancer-specific- as well as overall mortality after surgery for UTUC compared with those with a low pretreatment dNLR. Thus, this combined index should be considered as a potential prognostic biomarker in future.

[Acral eruptive nevi after chemotherapy in children with acute lymphoblastic leukemia]. / Nevos acrales eruptivos tras quimioterapia en niños afectados de leucemia linfoblástica aguda.

Eruptive melanocytic nevi have mainly been associated with blistering cutaneous diseases and with immunosuppression, particularly after renal allograft transplantation, hematological neoplasms, or HIV infection. Thus, immunosuppression has been suggested to increase the possibility of melanocyte proliferation. We report two cases of children with acute lymphoblastic leukemia who, after receiving chemotherapy, developed severe motor polyneuropathy, and sudden onset of multiple melanocytic nevi on the soles.

Nevos acrales eruptivos tras quimioterapia en niños afectados de leucemia linfoblástica aguda / Acral eruptive nevi after chemotherapy in children with acute lymphoblastic leukemia

La aparición repentina de múltiples nevos melanocíticos se ha relacionado fundamentalmente con enfermedades ampollosas cutáneas y con estados de inmunosupresión, especialmente tras trasplante renal alogénico, neoplasias hematológicas, o asociados a infección por el virus de la inmunodeficiencia humana. Por este motivo, se ha sugerido que la inmunosupresión favorecería la proliferación de los melanocitos. Describimos 2 casos de niños afectados por una leucemia linfoblástica aguda que, tras recibir quimioterapia, sufrieron una severa polineuropatía motora y la aparición súbita de múltiples nevos melanocíticos, fundamentalmente de localización plantar

Eruptive melanocytic nevi have mainly been associated with blistering cutaneous diseases and with immunosuppression, particularly after renal allograft transplantation, hematological neoplasms, or HIV infection. Thus, immunosuppression has been suggested to increase the possibility of melanocyte proliferation. We report two cases of children with acute lymphoblastic leukemia who, after receiving chemotherapy, developed severe motor polyneuropathy, and sudden onset of multiple melanocytic nevi on the soles