Assessing hematologic ratios as biomarkers for psychosocial distress

• Published in: Journal of clinical oncology Vol. 37; no. 4_suppl; p. 699
• Main Authors: Fong, Abigail, Lafaro, Kelly, Li, Arthur X, Melstrom, Laleh Golkar, Rodriguez, Jenny, Clark, Karen L., Loscalzo, Matthew J., Warner, Susanne
• Format: Journal Article
• Language: English
• Published: 01.02.2019
• ISSN: 0732-183X; 1527-7755
• DOI: 10.1200/JCO.2019.37.4_suppl.699

Abstract only 699 Background: Psychosocial distress is common among cancer patients and has been shown to have deleterious effects on a patient’s quality of life, treatment, and outcomes. Neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), and platelet-monocyte ratio (PMR) have been associated with poor outcomes in some cancers. Therefore we hypothesized that these ratios may be correlated to distress. This study looked at request for social work follow up as a surrogate marker for distress and investigated relationships between these ratios and markers of patient distress. Methods: A validated 48 item electronic distress screen was administered to patients in the medical and surgical oncology clinics of a large cancer center from 2009-2015. Patient requests for social work follow up were noted and patient charts reviewed for relevant labs and history. Patient demographics, NLR, LMR, PMR were reviewed. Chi-squared tests and univariate and multivariate regressions were performed to compare groups and relationships of variables and outcomes. Results: 43% of patients surveyed requested social work follow up. Of those, 75% received follow up, at a mean of 8 days. Non-Caucasian patients were more likely to request social work follow up (p = 0.03). Non-English speaking patients (p = 0.06) and those who saw medical oncologists trended towards significant desire for social work follow up. There was no significant correlation between NLR, PMR, LMR and desire to see a social worker. On multivariate analysis, patients with metastatic disease were less likely to want social work follow up (OR 0.43, 95% CI: 0.21-0.9, P = 0.02). Conclusions: In this study, non-white, non-English speaking patients, and those seeing medical oncologists were more likely to request social work follow up. We found no significant correlations between NLR, PMR, LMR and request for social work follow up. This suggests that desire for social work follow up is not a good correlate for physiologic distress in cancer patients. Further work is ongoing to provide better insight into determinants of psychosocial and physiologic stress in this patient population along with relevance of hematologic ratios.