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Meta-analysis links high platelet ratios to worse overall survival in adult glioblastoma patientsHigh blood cell ratios linked to shorter life in glioblastoma patients

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Key Takeaway
Note high platelet: lymphocyte ratio associated with worse overall survival in glioblastoma.

This meta-analysis evaluates the prognostic value of platelet indices in adults aged 16 years or older with WHO grade 4 diffuse astrocytoma. The analysis included 2609 patients for platelet: lymphocyte ratio, 1921 for platelet count, and 1234 for mean platelet volume. The primary outcome was overall survival assessed at follow-up periods of at least 3 months.

The pooled hazard ratio for high versus low platelet: lymphocyte ratio was 1.46 with a 95% CI [1.23, 1.74], indicating significantly worse overall survival. High platelet count showed a pooled hazard ratio of 1.38 with a 95% CI [1.00, 1.90], representing a borderline predictor of worse outcomes. Qualitative analysis demonstrated worse overall survival for high mean platelet volume and high mean platelet volume: platelet count ratio, though specific effect sizes were not reported.

High platelet distribution width was associated with worse overall survival based on data from one study, where effect sizes and confidence intervals were not reported. The authors note that evidence remains inconsistent regarding causality. These findings may help refine risk stratification and guide future mechanistic studies rather than establishing definitive treatment protocols.

Glioblastoma is a deadly form of brain cancer that often returns quickly after treatment. Doctors need better ways to predict which patients will struggle the most. A large review of medical records looked at simple blood tests to see if they could help. The team analyzed data from over 5,000 adults with this aggressive disease. They compared high levels of certain blood markers against low levels to see the difference in survival time.

The results were clear for one specific marker. Patients with a high platelet to lymphocyte ratio had a significantly worse outlook. This specific ratio was linked to a 46 percent higher risk of death compared to those with lower levels. The study looked at over 2,600 patients for this specific finding. Other blood markers showed mixed results. High platelet count suggested a worse outcome, but the data was less certain. High mean platelet volume and width also pointed toward poorer survival, though the numbers were not fully reported.

This research does not mean these blood tests cause the disease. It simply shows they are associated with a sicker state. The evidence is not perfect. Some parts of the data were incomplete or came from only one study. However, these findings could help doctors refine how they assess risk. Understanding these markers might guide future studies to understand why some patients fare worse than others. It is a step toward better care for those facing this difficult diagnosis.

What this means for you:
High blood cell ratios are linked to shorter life in glioblastoma patients.

Study Details

Study typeMeta analysis
Sample sizen = 30
EvidenceLevel 1
Follow-up192.0 mo
PublishedMay 2026
View Original Abstract ↓
Glioblastoma (GBM) is the most common malignant primary brain tumour and is associated with poor prognosis. Platelet-related factors have been linked to outcomes in GBM, but evidence remains inconsistent. This review evaluates their prognostic value for survival. We conducted a systematic review and meta-analysis of studies on preoperative thrombocytic factors in GBM. PubMed, MEDLINE, and Embase were searched from inception to January 2025 using MeSH terms. Eligible studies included observational cohort studies of adults (≥ 16 years) with WHO grade 4 diffuse astrocytoma (GBM), ≥ 30 participants, and ≥ 3 months' follow-up after resection. Random-effects meta-analysis using restricted maximum likelihood with Hartung-Knapp adjustment was used to pool hazard ratios (HRs) of high vs. low parameters on overall survival (OS). Study quality was assessed with the Newcastle-Ottawa Scale. 21 studies were included. 13 (n = 2609) reported HRs of high vs. low platelet: lymphocyte ratio (PLR, median threshold = 150), with high PLR significantly associated with worse OS (pooled HR = 1.46, 95% CI [1.23, 1.74]). Eight studies (n = 1921) assessed platelet count (PC, median threshold = 208*10/L), showing high PC was a borderline predictor of worse OS (pooled HR = 1.38, 95% CI [1.00, 1.90]). Four studies (n = 1234) examined mean platelet volume (MPV, median cut-off = 9.05 fL), which qualitatively demonstrated worse OS in patients with high MPV or high MPV: PC ratio. One study assessed platelet distribution width (PDW, threshold = 14.7 fL), finding worse OS in the high PDW group. High preoperative PLR is associated with poor prognosis in GBM, while high PC demonstrates borderline increased risk, which may help refine risk stratification and guide future mechanistic studies.
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