Background/Aim: Hodgkin lymphoma (HL) is a lymphoproliferative malignancy associated with inflammation. Plateletcrit (PCT) is a mean platelet volume (MPV) and platelet count-derived marker that is useful for evaluating malignancies and inflammatory diseases. International Prognostic Score (IPS-7) and more recently, IPS-3, are two indices indicating the prognosis of patients; however, widespread and easy to interpret prognostic markers are still needed for HL evaluation. Very few studies evaluating the prognostic significance of platelet indices in HL have been published, so we aimed to show the relationship between PCT and other adverse prognostic factors in HL and evaluate whether PCT can be used as a prognostic marker in HL. Methods: After excluding patients with insufficient data, 75 patients diagnosed with HL and 150 healthy controls were retrospectively analyzed in this case-control study. Evaluation of relationship of PCT and adverse HL prognostic factors, such as age, gender, hemoglobin, leukocytes, lymphocytes (absolute value and percentage), albumin, Ann Arbor stage and B symptoms, IPS-3 and-7 prognostic scores and post-treatment relapse, and progression-free survival of the patients were studied. Results: Mean MPV values were significantly lower, mean platelet values were significantly higher inpatient group (all P<0.001). Patients with high sedimentation had significantly higher mean PCT than those without (P=0.031) and a moderately positive correlation between PCT and sedimentation were found (r=0.33, P<0.01). Mean PCT values after treatment significantly decreased compared to baseline levels (P<0.001). Conclusion: PCT may be useful as a prognostic marker in HL. Further studies were needed to evaluate the relationship between PCT and other prognostic factors, such as IPS-3 and -7. '+st+' Asisstant Prof. Dr. of Hematology Department Assitant Dr. of Internal medicine Specialist of Public Health Klein U, Goossens T, Fischer M, Kanzler H, Braeuninger A, Rajewsky K, et al. Somatic hypermutation in normal and transformed human B cells. Immunol Rev. 1998 Apr;162:261-80. doi: 10.1111/j.1600-065x.1998.tb01447. x. PMID: 9602370. DOI: https://doi.org/10.1111/j.1600-065X.1998.tb01447.x Pallesen G, Hamilton-Dutoit SJ, Rowe M, Young LS. Expression of Epstein-Barr virus latent gene products in tumour cells of Hodgkin's disease. Lancet. 1991 Feb 9;337(8737):320-2. doi: 10.1016/0140-6736(91)90943-j. PMID: 1671232. DOI: https://doi.org/10.1016/0140-6736(91)90943-J Momotow J, Borchmann S, Eichenauer DA, Engert A, Sasse S. Hodgkin Lymphoma-Review on Pathogenesis, Diagnosis, Current and Future Treatment Approaches for Adult Patients. J Clin Med. 2021 Mar 8;10(5):1125. doi: 10.3390/jcm10051125. PMID: 33800409; PMCID: PMC7962816. DOI: https://doi.org/10.3390/jcm10051125 Küppers R, Engert A, Hansmann ML. Hodgkin lymphoma. J Clin Invest. 2012 Oct;122(10):3439-47. doi: 10.1172/JCI61245. Epub 2012 Oct 1. PMID: 23023715; PMCID: PMC3534167. DOI: https://doi.org/10.1172/JCI61245 von Tresckow B, Moskowitz CH. Treatment of relapsed and refractory Hodgkin Lymphoma. Semin Hematol. 2016 Jul;53(3):180-5. doi: 10.1053/j.seminhematol.2016.05.010. Epub 2016 May 12. PMID: 27496309; PMCID: PMC5637390. DOI: https://doi.org/10.1053/j.seminhematol.2016.05.010 Chen L, Han X. Anti-PD-1/PD-L1 therapy of human cancer: past, present, and future. J Clin Invest. 2015 Sep;125(9):3384-91. doi: 10.1172/JCI80011. Epub 2015 Sep 1. PMID: 26325035; PMCID: PMC4588282. DOI: https://doi.org/10.1172/JCI80011 Moy RH, Younes A. Immune Checkpoint Inhibition in Hodgkin Lymphoma. Hemasphere. 2018 Feb 16;2(1):e20. doi: 10.1097/HS9.0000000000000020. PMID: 31723749; PMCID: PMC6745954. DOI: https://doi.org/10.1097/HS9.0000000000000020 Franco AT, Corken A, Ware J. Platelets at the interface of thrombosis, inflammation, and cancer. Blood. 2015 Jul 30;126(5):582-8. doi: 10.1182/blood-2014-08-531582. Epub 2015 Jun 24. PMID: 26109205; PMCID: PMC4520875. DOI: https://doi.org/10.1182/blood-2014-08-531582 Ustaoglu G, Erdal E, Inanır M. Does periodontitis affect mean platelet volume (MPV) and plateletcrit (PCT) levels in healthy adults? Rev Assoc Med Bras (1992). 2020 May 15;66(2):133-8. doi: 10.1590/1806-9282.66.2.133. PMID: 32428146. DOI: https://doi.org/10.1590/1806-9282.66.2.133 Hur JY, Lee HY, Chang HJ, Choi CW, Kim DH, Eo WK. Preoperative plateletcrit is a Prognostic Biomarker for Survival in Patients with Non-Small Cell Lung Cancer. J Cancer. 2020 Feb 25;11(10):2800-7. doi: 10.7150/jca.41122. PMID: 32226498; PMCID: PMC7086273. DOI: https://doi.org/10.7150/jca.41122 Diefenbach CS, Li H, Hong F, Gordon LI, Fisher RI, Bartlett NL, et al. Evaluation of the International Prognostic Score (IPS-7) and a Simpler Prognostic Score (IPS-3) for advanced Hodgkin lymphoma in the modern era. Br J Haematol. 2015 Nov;171(4):530-8. doi: 10.1111/bjh.13634. Epub 2015 Sep 7. PMID: 26343802; PMCID: PMC4881845. DOI: https://doi.org/10.1111/bjh.13634 Karagoz B, Sucullu I, Sayan O, Bilgi O, Tuncel T, Filiz A, et al. Platelet indices in patients with colorectal cancer. Open Medicine. 2010;5(3): 365-8. doi: 10.2478/s11536-009-0077-7 DOI: https://doi.org/10.2478/s11536-009-0077-7 Korniluk A, Koper-Lenkiewicz OM, Kamińska J, Kemona H, Dymicka-Piekarska V. Mean Platelet Volume (MPV): New Perspectives for an Old Marker in the Course and Prognosis of Inflammatory Conditions. Mediators Inflamm. 2019 Apr 17; 2019:9213074. doi: 10.1155/2019/9213074. PMID: 31148950; PMCID: PMC6501263. DOI: https://doi.org/10.1155/2019/9213074 Kumagai S, Tokuno J, Ueda Y, Marumo S, Shoji T, Nishimura T, et al. Prognostic significance of preoperative mean platelet volume in resected non-small-cell lung cancer. Mol Clin Oncol. 2015 Jan;3(1):197-201. doi: 10.3892/mco.2014.436. Epub 2014 Oct 6. PMID: 25469294; PMCID: PMC4251106. DOI: https://doi.org/10.3892/mco.2014.436 Shen WJ, Fu S, Li N, Li LL, Cao ZG, Li C, et al. Decreased Mean Platelet Volume is Associated with Cervical Cancer Development. Asian Pac J Cancer Prev. 2017 Jul 27;18(7):1769-72. doi: 10.22034/APJCP.2017.18.7.1769. PMID: 28749103; PMCID: PMC5648377. Rupa-Matysek J, Gil L, Barańska M, Dytfeld D, Komarnicki M. Mean platelet volume as a predictive marker for venous thromboembolism in patients treated for Hodgkin lymphoma. Oncotarget. 2018 Apr 20;9(30):21190-200. doi: 10.18632/oncotarget.25002. PMID: 29765530; PMCID: PMC5940371. DOI: https://doi.org/10.18632/oncotarget.25002 Plantureux L, Mège D, Crescence L, Dignat-George F, Dubois C, Panicot-Dubois L. Impacts of Cancer on Platelet Production, Activation and Education and Mechanisms of Cancer-Associated Thrombosis. Cancers (Basel). 2018 Nov 14;10(11):441. doi: 10.3390/cancers10110441. PMID: 30441823; PMCID: PMC6266827. DOI: https://doi.org/10.3390/cancers10110441 Randi ML, Rossi C, Barbone E, Pietrogrande F, Girolami A. Incidence of thrombocytosis in lymphomas. Leuk Lymphoma. 1992 May;7(1-2):139-41. doi: 10.3109/10428199209053614. PMID: 1472925. DOI: https://doi.org/10.3109/10428199209053614 Zhu X, Cao Y, Lu P, Kang Y, Lin Z, Hao T, et al. Evaluation of platelet indices as diagnostic biomarkers for colorectal cancer. Sci Rep. 2018 Aug 7;8(1):11814. doi: 10.1038/s41598-018-29293-x. PMID: 30087357; PMCID: PMC6081379. DOI: https://doi.org/10.1038/s41598-018-29293-x Engert A, Ballova V, Haverkamp H, Pfistner B, Josting A, Dühmke E, et al. Hodgkin's lymphoma in elderly patients: a comprehensive retrospective analysis from the German Hodgkin's Study Group. J Clin Oncol. 2005 Aug 1;23(22):5052-60. doi: 10.1200/JCO.2005.11.080. Epub 2005 Jun 13. PMID: 15955904. DOI: https://doi.org/10.1200/JCO.2005.11.080 Tao Y, He X, Qin Y, Liu P, Zhou S, Yang J, et al. Low platelet/platelet distribution width and high platelet/lymphocyte ratio are adverse prognostic factors in patients with newly diagnosed advanced Hodgkin lymphoma. Leuk Lymphoma. 2021 Jul 23:1-11. doi: 10.1080/10428194.2021.1953015. Epub ahead of print. PMID: 34296652. DOI: https://doi.org/10.1080/10428194.2021.1953015 Reddy JP, Hernandez M, Gunther JR, Dabaja BS, Martin GV, Jiang W, et al. Pre-treatment neutrophil/lymphocyte ratio and platelet/lymphocyte ratio are prognostic of progression in early-stage classical Hodgkin lymphoma. Br J Haematol. 2018 Feb;180(4):545-9. doi: 10.1111/bjh.15054. Epub 2017 Dec 21. PMID: 29271057. DOI: https://doi.org/10.1111/bjh.15054 Copyright (c) 2023 Demircan Ozbalci, Emine Guchan Alanoglu, Kamuran Yuceer, Hande Nur Eroglu This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Background/Objectives: Metachronous lung-limited oligometastatic disease represents a biologically heterogeneous state in which patient selection for pulmonary metastasectomy remains challenging. While systemic inflammation–nutrition indices have shown prognostic value across malignancies, their relevance in this strictly defined surgical setting is not well established. Methods: We conducted a retrospective single-center cohort study including 109 patients with isolated metachronous pulmonary recurrence who underwent curative intent R0 metastasectomy between September 2015 and April 2024. Preoperative systemic biomarkers, including neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), pan-immune-inflammation value (PIV), and monocyte-to-albumin ratio (MAR), were evaluated using receiver operating characteristic (ROC) analysis and multivariable Cox models to determine their association with overall survival (OS) and progression-free survival (PFS). Clinicopathological variables, such as lymph node involvement and metastatic burden, were incorporated into the adjusted models. Results: The median age of the cohort was 61 years (range, 29–82 years), and the sex distribution was balanced (48.6% female and 51.4% male), with 62.4% of patients being younger than 65 years. Among the systemic indices evaluated, monocyte-weighted biomarkers demonstrated the strongest prognostic performance. The MAR showed the highest discriminative ability for mortality (AUC, 0.749; p < 0.001), followed by the SIRI (AUC, 0.682; p = 0.007). In multivariable analyses, MAR independently predicted OS (p = 0.043) and PFS (p = 0.023), while SIRI independently predicted PFS (p = 0.043). Lymph node involvement remained the dominant adverse prognostic factor for both outcomes (p < 0.001); however, monocyte-weighted indices provided additional prognostic value beyond conventional anatomic criteria. Conclusions: Preoperative SIRI and MAR capture host immune–metabolic states that are relevant to postoperative trajectories and may refine risk stratification in candidates for pulmonary metastasectomy. These readily obtainable markers warrant prospective validation within biologically integrated selection frameworks.

Background/objectives Patients with metastatic prostate cancer (mPC) represent a population with a higher proportion of elderly patients compared to other patient groups. Androgen receptor pathway inhibitors (ARPISs) are frequently used in current treatment regimens. Although the Prognostic Nutritional Index (PNI) is widely utilized, its stand alone capacity to accurately predict overall survival (OS) and progression-free survival (PFS) remains limited. This study aimed to evaluate the prognostic value of PNI in mPC patients treated with ARPIs and to optimize survival predictions by developing integrated multivariable logistic and Cox regression models. Methods PNI was calculated at baseline and third month after treatment initiation. To assess cross-sectional predictive capability, multivariable logistic regression models were developed for OS and PFS events, and their diagnostic performance was evaluated using Receiver Operating Characteristic (ROC) curve analysis. Subsequently, time-to-event dynamics and hazard ratios were analyzed using univariable and multivariable Cox proportional hazards regression. Results The multivariable logit model demonstrated robust predictive performance for survival outcomes. Utilizing the model-derived optimal probability cutoff of 0.343, patients were successfully stratified into distinct prognostic cohorts. The high-probability risk group (≥ 0.343, n = 86) exhibited a significantly worse prognosis, with accelerated curve decline and earlier, more frequent mortality. In contrast, the low-probability group (< 0.343, n = 51) showed a favorable prognosis, maintaining an approximate 30% survival rate up to the 75th month (Log-rank p = 0.009). Conclusion Evaluating nutrition alone is not enough to predict how mPC patients will progress. By tracking PNI changes over time and combining them into multivariable logistic model, we can much better predict overall survival and progression-free survival. In practice, using our model's 0.343 cutoff score allows us to easily catch high-risk patients early on, helping physician step in with personalized nutritional and medical support.

Background and Objectives: Metastatic pancreatic ductal adenocarcinoma (PDAC) continues to carry a poor prognosis despite advances in treatment, underscoring the need for simple and accessible biomarkers that reflect tumor–host interactions. The Global Immune–Nutrition–Inflammation Index (GINI), which combines inflammatory, immune, and nutritional parameters, may offer improved prognostic stratification compared with conventional indices. Materials and Methods: This retrospective cohort study included 126 patients with metastatic PDAC treated between 2015 and 2024. GINI, neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) were calculated using baseline laboratory data. Discriminative ability was evaluated by receiver operating characteristic (ROC) analysis. Survival outcomes were assessed using Kaplan–Meier curves and Cox proportional hazards models. Results: Among the evaluated indices, GINI showed the best discriminative performance (AUC, 0.769; 95% CI, 0.637–0.900), with a sensitivity of 78.8% and specificity of 76.9%. Patients with lower GINI values had significantly longer overall survival than those with higher values (median OS, 11.0 vs. 7.0 months; p = 0.014). Although progression-free survival differed statistically (p = 0.006), median PFS was the same in both groups (5.0 months). In univariable analysis, higher GINI was associated with worse OS (HR, 1.67; p = 0.022) and PFS (HR, 1.75; p = 0.012). However, in multivariable analysis, ECOG performance status remained the only consistent independent predictor, and GINI was no longer significant. Conclusions: GINI is a practical and biologically meaningful biomarker that improves risk discrimination in metastatic PDAC. While it does not retain independent prognostic significance, its ability to capture the overall tumor–host interaction supports its use as a complementary tool for baseline risk assessment.

Background and Aim: Anti-epidermal growth factor receptor (EGFR) therapy is commonly associated with skin toxicity, which may reflect treatment response. This study evaluated the prognostic significance of anti-EGFR-related skin toxicity in patients with RAS wild-type metastatic colorectal cancer (mCRC) receiving palliative chemotherapy. Materials and Methods: We retrospectively analyzed 256 RAS wild-type mCRC patients treated with anti-EGFR monoclonal antibodies at Erciyes University, Kayseri, Turkey (June 2011–February 2024). Survival was estimated using the Kaplan-Meier method with log-rank comparisons. A landmark analysis at 2 months was performed to address guarantee-time bias. Univariate and multivariate Cox regression analyses were used to identify independent prognostic factors. Results: The median PFS was 17 months in patients with grade ≥ 2 skin toxicity versus 8 months in those with grade < 2 skin toxicity (p < 0.001). The median OS was 32 and 21 months, respectively (p < 0.001). In the landmark-adjusted multivariate analysis, grade ≥ 2 skin toxicity was an independent prognostic factor for both PFS (HR 0.52, 95% CI 0.39–0.70, p < 0.001) and OS (HR 0.50, 95% CI 0.37–0.68, p < 0.001). Additional independent factors for OS included albumin, LDH, peritoneal metastasis, age, tumor sidedness, and BMI. The objective response rates were 53.9% and 11.3% in the grade ≥ 2 and grade < 2 groups, respectively (p < 0.001). Conclusions: Grade ≥ 2 skin toxicity was significantly associated with longer PFS, OS, and a higher response rate, and was confirmed as an independent prognostic factor in multivariate analysis. These findings suggest that skin toxicity may serve as a non-invasive marker of treatment efficacy. Prospective studies with time-dependent methodologies are needed to validate these results.