P02.04.A Preoperative neutrophil, thrombocyte and monocyte to lymphocyte ratios as independent prognostic factors for patient survival in WHO 2021 glioblastoma multiforme

Abstract Background Glioblastoma (GBM) is the most common malignant primary central nervous system (CNS) tumor. It a fast-growing and extremely aggressive malignancy with short postoperative survival time of little more than year. The tumor-immune interactions are complex can be measured as local phenomena - e.g., tumor-infiltrating lymphocytes, or systemic events lymphopenia, neutropenia, etc. cell numbers allowing for estimation type immune reaction against Material Methods A retrospective non-clinical approach was utilized means study. Patients histologically molecular verified GBM, corresponding to guidelines 2021 WHO CNS tumor classification, diagnosed in three-year interval (February 2018-2021) single tertiary healthcare institution were included. infectious, inflammatory, autoimmune, hematological diseases, well those another location, excluded. Data regarding patient demographics, preoperative peripheral blood counts (neutrophils, platelets, monocytes ratio lymphocytes) compared survival. Preoperative ratios calculated absolute values. For cutoff values we used generally accepted ones >4 neutrophil lymphocyte (NLR), >200 thrombocyte (TLR), >0.25 monocyte (MLR). Results statistically analyzed MedCalc version 19.7.1 Kaplan-Meier method. total 22 patients fit established criteria, male female 2.14:1, mean age 66.23 years, 255.72 days (8.04 months, range 24-801 days). Eight had an elevation NLR five PLR, no statistical correlation Six increase MLR significant (p=0.0044) shorter Synergic PLR did not show significance, while synergic showed added benefit, comparison within MGMT promoter methylation groups. Conclusion Elevation NLR, good independent prognostic marker mutationally GBM. Acknowledgments * contributed equally work should considered co-first authors.Financing: Medical University Varna Scientific Fund, grant number 19010 National scientific fund young researchers (Republic Bulgaria) 2990/07.06.2021 Ethical approval: committee on ethics approval protocol 93/21.05.2020