{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T03:14:54Z","timestamp":1792984494833,"version":"4.5.0"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T00:00:00Z","timestamp":1760918400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T00:00:00Z","timestamp":1760918400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100007397","name":"Charles University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100007397","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Neurooncol"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Circulating inflammatory indices derived from routine blood counts may offer pragmatic prognostic information in glioblastoma (GB), yet the prognostic role of plateletcrit (PCT) and of peri-treatment dynamics in leukocyte\u2013platelet coupling remains underexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively studied 95 adults with histologically confirmed GB (48 men, 47 women; median age 64.5 years) treated adjuvantly with radiotherapy and chemotherapy with complete blood counts obtained at four windows: pre-operative, post-operative, pre-adjuvant, and post-adjuvant. From leukocytes, platelets (PLT), plateletcrit (PCT), and mean platelet volume (MPV) we derived all within-timepoint ratios and inter-timepoint differences (\u0394). Overall survival (OS) in days was modeled using Cox proportional hazards (per +\u20091 SD), with Benjamini\u2013Hochberg false-discovery summaries; a multivariable model adjusted for age, sex, extent of resection, radiotherapy, concomitant temozolomide (TMZ), and number of adjuvant TMZ cycles was calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median overall survival (OS) was 406 days, with 80 deaths. In univariate models, dynamic indices predominated: the post-operative rise in leukocytes relative to plateletcrit (\u0394 post-op\u2009\u2212\u2009pre-op leu\/PCT) showed the strongest adverse association (HR 1.60, 95% CI 1.22\u20132.10;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0007; BH\u2013FDR q\u2009=\u20090.09), with concordant signals for \u0394 leu\/PLT (HR 1.43, 95% CI 1.14\u20131.79;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) and a protective inverse for \u0394 PCT\/leu (HR 0.66, 95% CI 0.50\u20130.87;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). Cross-sectionally, higher post-operative leu\/PCT and leu\/PLT and higher post-adjuvant leukocytes and leu\/MPV were adverse (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). In the multivariable model adjusting for age, sex, extent of resection, radiotherapy, concomitant temozolomide (TMZ), and number of adjuvant TMZ cycles, \u0394 leu\/PCT remained independently associated with worse OS (HR 1.62, 95% CI 1.04\u20132.52;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.031), while concomitant TMZ (HR 0.18, 95% CI 0.05\u20130.68;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012) and greater adjuvant TMZ exposure (per +\u20091 SD; HR 0.48, 95% CI 0.29\u20130.78;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) were protective.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dynamic leukocyte\u2013platelet coupling\u2014especially \u0394 (post-op\u2009\u2212\u2009pre-op) leu\/PCT\u2014provides independent prognostic information beyond standard covariates. CBC-based trajectories are low-cost and scalable and warrant prospective validation. Interpretation is limited by the absence of systematic MGMT methylation data and requires external validation and comparison with other prognostic scoring systems.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11060-025-05302-8","type":"journal-article","created":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T07:28:49Z","timestamp":1760945329000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Perioperative leukocyte\u2013plateletcrit shift as a prognostic signature in glioblastoma"],"prefix":"10.1007","volume":"176","author":[{"given":"Petr","family":"Krupa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filip","family":"Kotek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marketa","family":"Krupova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Paulikova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra","family":"Kasparova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Cesak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,20]]},"reference":[{"key":"5302_CR1","doi-asserted-by":"publisher","first-page":"987","DOI":"10.1056\/NEJMoa043330","volume":"352","author":"R Stupp","year":"2005","unstructured":"Stupp R et al (2005) Radiotherapy plus concomitant and adjuvant Temozolomide for glioblastoma. 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The study was approved by Local Ethics committee (No. 202509 P03) and conducted in accordance with the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"27"}}