Perioperative leukocyte-plateletcrit shift as a prognostic signature in glioblastoma

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00179906%3A_____%2F25%3A10504840" target="_blank" >RIV/00179906:_____/25:10504840 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216208:11150/25:10504840

Výsledek na webu

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=ctruQvlM7n" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=ctruQvlM7n</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1007/s11060-025-05302-8" target="_blank" >10.1007/s11060-025-05302-8</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Perioperative leukocyte-plateletcrit shift as a prognostic signature in glioblastoma

Popis výsledku v původním jazyce

Purpose Circulating inflammatory indices derived from routine blood counts may offer pragmatic prognostic information in glioblastoma (GB), yet the prognostic role of plateletcrit (PCT) and of peri-treatment dynamics in leukocyte-platelet coupling remains underexplored. Methods We retrospectively studied 95 adults with histologically confirmed GB (48 men, 47 women; median age 64.5 years) treated adjuvantly with radiotherapy and chemotherapy with complete blood counts obtained at four windows: pre-operative, post-operative, pre-adjuvant, and post-adjuvant. From leukocytes, platelets (PLT), plateletcrit (PCT), and mean platelet volume (MPV) we derived all within-timepoint ratios and inter-timepoint differences (Delta). Overall survival (OS) in days was modeled using Cox proportional hazards (per + 1 SD), with Benjamini-Hochberg false-discovery summaries; a multivariable model adjusted for age, sex, extent of resection, radiotherapy, concomitant temozolomide (TMZ), and number of adjuvant TMZ cycles was calculated. Results Median overall survival (OS) was 406 days, with 80 deaths. In univariate models, dynamic indices predominated: the post-operative rise in leukocytes relative to plateletcrit (Delta post-op - pre-op leu/PCT) showed the strongest adverse association (HR 1.60, 95% CI 1.22-2.10; p = 0.0007; BH-FDR q = 0.09), with concordant signals for Delta leu/PLT (HR 1.43, 95% CI 1.14-1.79; p = 0.002) and a protective inverse for Delta PCT/leu (HR 0.66, 95% CI 0.50-0.87; p = 0.003). Cross-sectionally, higher post-operative leu/PCT and leu/PLT and higher post-adjuvant leukocytes and leu/MPV were adverse (all p &lt; 0.05). In the multivariable model adjusting for age, sex, extent of resection, radiotherapy, concomitant temozolomide (TMZ), and number of adjuvant TMZ cycles, Delta leu/PCT remained independently associated with worse OS (HR 1.62, 95% CI 1.04-2.52; p = 0.031), while concomitant TMZ (HR 0.18, 95% CI 0.05-0.68; p = 0.012) and greater adjuvant TMZ exposure (per + 1 SD; HR 0.48, 95% CI 0.29-0.78; p = 0.003) were protective. Conclusions Dynamic leukocyte-platelet coupling-especially Delta (post-op - pre-op) leu/PCT-provides independent prognostic information beyond standard covariates. CBC-based trajectories are low-cost and scalable and warrant prospective validation. Interpretation is limited by the absence of systematic MGMT methylation data and requires external validation and comparison with other prognostic scoring systems.

Název v anglickém jazyce

Perioperative leukocyte-plateletcrit shift as a prognostic signature in glioblastoma

Popis výsledku anglicky

Purpose Circulating inflammatory indices derived from routine blood counts may offer pragmatic prognostic information in glioblastoma (GB), yet the prognostic role of plateletcrit (PCT) and of peri-treatment dynamics in leukocyte-platelet coupling remains underexplored. Methods We retrospectively studied 95 adults with histologically confirmed GB (48 men, 47 women; median age 64.5 years) treated adjuvantly with radiotherapy and chemotherapy with complete blood counts obtained at four windows: pre-operative, post-operative, pre-adjuvant, and post-adjuvant. From leukocytes, platelets (PLT), plateletcrit (PCT), and mean platelet volume (MPV) we derived all within-timepoint ratios and inter-timepoint differences (Delta). Overall survival (OS) in days was modeled using Cox proportional hazards (per + 1 SD), with Benjamini-Hochberg false-discovery summaries; a multivariable model adjusted for age, sex, extent of resection, radiotherapy, concomitant temozolomide (TMZ), and number of adjuvant TMZ cycles was calculated. Results Median overall survival (OS) was 406 days, with 80 deaths. In univariate models, dynamic indices predominated: the post-operative rise in leukocytes relative to plateletcrit (Delta post-op - pre-op leu/PCT) showed the strongest adverse association (HR 1.60, 95% CI 1.22-2.10; p = 0.0007; BH-FDR q = 0.09), with concordant signals for Delta leu/PLT (HR 1.43, 95% CI 1.14-1.79; p = 0.002) and a protective inverse for Delta PCT/leu (HR 0.66, 95% CI 0.50-0.87; p = 0.003). Cross-sectionally, higher post-operative leu/PCT and leu/PLT and higher post-adjuvant leukocytes and leu/MPV were adverse (all p &lt; 0.05). In the multivariable model adjusting for age, sex, extent of resection, radiotherapy, concomitant temozolomide (TMZ), and number of adjuvant TMZ cycles, Delta leu/PCT remained independently associated with worse OS (HR 1.62, 95% CI 1.04-2.52; p = 0.031), while concomitant TMZ (HR 0.18, 95% CI 0.05-0.68; p = 0.012) and greater adjuvant TMZ exposure (per + 1 SD; HR 0.48, 95% CI 0.29-0.78; p = 0.003) were protective. Conclusions Dynamic leukocyte-platelet coupling-especially Delta (post-op - pre-op) leu/PCT-provides independent prognostic information beyond standard covariates. CBC-based trajectories are low-cost and scalable and warrant prospective validation. Interpretation is limited by the absence of systematic MGMT methylation data and requires external validation and comparison with other prognostic scoring systems.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30103 - Neurosciences (including psychophysiology)

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2025

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Journal of Neuro-Oncology

ISSN

0167-594X

e-ISSN

1573-7373

Svazek periodika

176

Číslo periodika v rámci svazku

1

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

10

Strana od-do

27

Kód UT WoS článku

001597462100005

EID výsledku v databázi Scopus

2-s2.0-105019329567