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The following is a summary of “Neutrophil-to-Lymphocyte Ratio as a Biomarker for Clinical Response After Autologous Hematopoietic Stem Cell Transplantation in Systemic Sclerosis,” published in the November 2024 issue of Rheumatology by Keret et al. 

Systemic sclerosis (SSc) affects multiple organs, complicating the assessment of treatment response. A baseline NLR >2.95 is linked to severe disease progression and reduced 5-year survival in SSc. 

Researchers conducted a retrospective study to assess NLR changes as a biomarker for treatment response in SSc. 

They recruited progressive diffuse patients suffering from SSc treated with autologous hematopoietic stem cell transplantation (AHSCT), rituximab and mycophenolate mofetil (combination therapy), or CAR-T cell therapy (CAR-T group), along with healthy controls (HC group). They assessed NLR, modified Rodnan Skin Score (mRSS), and forced vital capacity (FVC)% predicted over a 2-year period. 

The results showed that 15 patients were in the AHSCT group, 15 in the combination group, and 6 in the CAR-T group. Baseline mean NLR was higher in all treatment groups compared to HC. Each treatment group showed significant improvement in mRSS and FVC% up to 12 months. NLR decreased significantly in the AHSCT group up to 24 months, correlating with mRSS and FVC%. NLR increased above 3 in 2 patients who relapsed after AHSCT. 

They concluded that NLR correlated with treatment outcomes in SSc following AHSCT, suggesting that a decrease in NLR may indicate remission, while an increase may signal exacerbation. Further studies were needed to validate these findings. 

Source: academic.oup.com/rheumatology/advance-article-abstract/doi/10.1093/rheumatology/keae606/7863300