Neutrophil-to-lymphocyte ratio and monocyte-to-lymphocyte ratio are associated with a 2-year relapse in patients with multiple sclerosis

• Published in: Multiple sclerosis and related disorders Vol. 58; p. 103514
• Main Authors: Huang, Wei-Chin, Lin, Hui-Chen, Yang, Yao-Hsu, Hsu, Che-Wei, Chen, Nai-Ching, Tsai, Wan-Chen, Cheng, Ben-Chung, Tsai, Nai-Wen
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.02.2022
• Subjects: Humans; Lymphocytes; Monocyte-to-lymphocyte ratio; Monocytes; Multiple Sclerosis; Neutrophil-to-lymphocyte ratio; Neutrophils; Outcome; Prognosis; Recurrence; Relapse; Retrospective Studies; MLR; Multiple sclerosis; Relapse; Monocyte-to-lymphocyte ratio; NLR; Neutrophil-to-lymphocyte ratio; MS; Outcome; CNS; WBC; DMT
• ISSN: 2211-0348; 2211-0356
• DOI: 10.1016/j.msard.2022.103514

•More MS patients with relapse have increased NLR/MLR than those without relapse.•Patients with increased NLR or MLR had a higher risk of 2-years MS relapse.•NLR and MLR can be considered as biomarkers for MS disease activity assessment. The association between increased neutrophil-to-lymphocyte ratio (NLR) and multiple sclerosis has been demonstrated in several studies. The monocyte-to-lymphocyte ratio (MLR) is an emerging biomarker for disease monitoring. Moreover, there has not been a published Taiwanese study to date. To investigate the correlation of NLR, MLR and white blood cell (WBC) count as possible biomarkers for predicting a 2-year relapse in patients with multiple sclerosis (MS). A total of 641 Taiwanese patients with MS were enrolled in the present study between January 1, 2001, and December 31, 2018. We collected data on NLR, MLR, WBC count, disease-modifying therapy (DMT) use, and the time between first diagnosis and first relapse in all patients within a 2-year duration. In the relapse group, there were significantly more patients with NLR >median or MLR >median (p = 0.006 and p = 0.020, respectively). There were also more patients with WBC count >median, although the difference was not statically significant (p = 0.069). The adjusted hazard ratio for relapse and NLR >median was 1.61(p = 0.008). The adjusted hazard ratio for relapse and MLR >median was 1.43 (p = 0.044). Patients with NLR >median or MLR >median had a significantly (p = 0.008 and p = 0.039, respectively) increased risk of MS relapse in the 2 years, compared with those who had NLR <median or MLR <median. NLR and MLR are widely available, fast and measurable inflammatory markers for predicting the relapse risk of MS patients.