{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:05:16Z","timestamp":1790802316085,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,4,28]],"date-time":"2024-04-28T00:00:00Z","timestamp":1714262400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,4,28]],"date-time":"2024-04-28T00:00:00Z","timestamp":1714262400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Previous studies have shown that neutrophil\u2010to\u2010lymphocyte (NLR) ratio at diagnosis and early lymphocytes recovery on doxorubicin\u2010based chemotherapy, may impact the outcome in patients with osteosarcoma (OST). This study aimed to evaluate the prognostic value of hemogram parameters in patients with OST treated with high\u2010dose methotrexate and etoposide\/ifosfamide (M\u2010EI) chemotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed the prognostic value of various hemogram parameters at diagnosis and during therapy in a large consecutive cohort of patients with OST included in the French OS2006 trial and treated with M\u2010EI chemotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 164 patients were analyzed. The median age was 14.7\u00a0years (interquartile range [IQR]: 11.7\u201317). Median follow\u2010up was 5.6\u00a0years (IQR: 3.3\u20137.7\u00a0years). Three\u2010year event\u2010free survival (EFS) and overall survival (OS) were 71.5% (95% confidence interval [CI]: 64%\u201378%) and 86.4% (95% CI: 80%\u201391%), respectively. In univariate analysis, blood count parameters at diagnosis and early lymphocyte recovery at Day 14 were not found prognostic of survival outcomes. By contrast, an increase of NLR ratio at Day 1 of the first EI chemotherapy (NLR\u2010W4) was associated with reduced OS in univariate (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.0044) and multivariate analysis (hazards ratio [HR]\u00a0=\u00a01.3, 95% CI: 1.1\u20131.5;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.002), although not with EFS. After adjustment on histological response and metastatic status, an increase of the ratio NLR\u2010W4 of 1 was associated with an increased risk of death of 30%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We identified NLR\u2010W4 as a potential early biomarker for survival in patients with OST treated with M\u2010EI chemotherapy. Further studies are required to confirm the prognostic value of NLR and better identify immune mechanisms involved in disease surveillance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pbc.31029","type":"journal-article","created":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T00:28:40Z","timestamp":1714350520000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Prognostic value of hemogram parameters in osteosarcoma: The French OS2006 experience"],"prefix":"10.1002","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5926-8437","authenticated-orcid":false,"given":"Paul","family":"Bastard","sequence":"first","affiliation":[{"name":"Department of Oncology for Child and Adolescents University Paris\u2010Saclay, Gustave Roussy  Villejuif France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Cozic","sequence":"additional","affiliation":[{"name":"Biostatistics Unit Gustave Roussy  Villejuif France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00e9gis","family":"Brion","sequence":"additional","affiliation":[{"name":"Centre de Recherche en Canc\u00e9rologie et Immunologie Int\u00e9gr\u00e9e Nantes Angers (CRCI2NA) INSERM UMR 1307 CNRS UMR 6075 Universit\u00e9 de NantesCHU de Nantes  Nantes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Gaspar","sequence":"additional","affiliation":[{"name":"Department of Oncology for Child and Adolescents University Paris\u2010Saclay, Gustave Roussy  Villejuif France"},{"name":"INSERM U1015 University Paris\u2010Saclay, Gustave Roussy  Villejuif France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Piperno\u2010Neumann","sequence":"additional","affiliation":[{"name":"Medical Oncology Department Institut Curie  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille","family":"Cordero","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Department CHU\u2010H\u00f4pital de la M\u00e8re et de l'Enfant  Nantes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estelle","family":"Lecul\u00e9e\u2010Th\u00e9baud","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Department CHU\u2010H\u00f4pital de la M\u00e8re et de l'Enfant  Nantes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Gomez\u2010Mascard","sequence":"additional","affiliation":[{"name":"Department of Pathology CHU, IUCT\u2010Oncopole, University of Toulouse, Eq19. ONCOSARC CRCT, UMR 1037 Inserm\/UT3, ERL 5294 CNRS  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7oise","family":"R\u00e9dini","sequence":"additional","affiliation":[{"name":"Centre de Recherche en Canc\u00e9rologie et Immunologie Int\u00e9gr\u00e9e Nantes Angers (CRCI2NA) INSERM UMR 1307 CNRS UMR 6075 Universit\u00e9 de NantesCHU de Nantes  Nantes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonin","family":"Marchais","sequence":"additional","affiliation":[{"name":"Department of Oncology for Child and Adolescents University Paris\u2010Saclay, Gustave Roussy  Villejuif France"},{"name":"INSERM U1015 University Paris\u2010Saclay, Gustave Roussy  Villejuif France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raina","family":"Ikonomova","sequence":"additional","affiliation":[{"name":"Medical Oncology Department Institut Curie  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8749-9443","authenticated-orcid":false,"given":"Morgane","family":"Cleirec","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Department CHU\u2010H\u00f4pital de la M\u00e8re et de l'Enfant  Nantes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val\u00e9rie","family":"Laurence","sequence":"additional","affiliation":[{"name":"Medical Oncology Department Institut Curie  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1774-778X","authenticated-orcid":false,"given":"Charlotte","family":"Rigaud","sequence":"additional","affiliation":[{"name":"Department of Oncology for Child and Adolescents University Paris\u2010Saclay, Gustave Roussy  Villejuif 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