Neutrophil-to-lymphocyte ratio half reduction as a surrogate of molecular response in polycythemia vera treated with ropeginterferon alfa-2b

Seug Yun Yoon; Sung Soo Yoon; Deok Hwan Yang; Gyeong Won Lee; Sang Kyun Sohn; Ho Jin Shin; Sung Hwa Bae; Chul Won Choi; Eun Ji Choi; June Won Cheong; Soo Mee Bang; Joon Seong Park; Yong Park; Young Hoon Park; Sung Eun Lee

doi:10.1177/20406207261431904

Neutrophil-to-lymphocyte ratio half reduction as a surrogate of molecular response in polycythemia vera treated with ropeginterferon alfa-2b

Seug Yun Yoon
, Sung Soo Yoon
, Deok Hwan Yang
, Gyeong Won Lee
, Sang Kyun Sohn
, Ho Jin Shin
, Sung Hwa Bae
, Chul Won Choi
, Eun Ji Choi
, June Won Cheong
, Soo Mee Bang
, Joon Seong Park
, Yong Park
, Young Hoon Park
, Sung Eun Lee

Department of Internal Medicine

Soonchunhyang University
Seoul National University
Chonnam National University
Gyeongsang National University
Kyungpook National University
Pusan National University
Catholic University of Daegu
Korea University
University of Ulsan
Yonsei University
Ajou University
Ewha Womans University

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Polycythemia vera (PV) is a myeloproliferative neoplasm driven by JAK2 V617F mutations. Ropeginterferon alfa-2b effectively reduces both hematologic parameters and JAK2 allele burden, but molecular monitoring is not always readily available. Objectives: To evaluate whether a ⩾50% reduction in the neutrophil-to-lymphocyte ratio (NLR) can serve as a surrogate marker of hematologic and molecular response during ropeginterferon therapy. Design: Secondary analysis of a multicenter, phase II, open-label trial in South Korea. Methods: Ninety-five patients with PV received ropeginterferon alfa-2b biweekly for 48 weeks. NLR and JAK2 allele burden were serially measured, and generalized estimating equations and logistic regression were used to assess associations. Results: NLR half reduction significantly predicted hematologic response (week 24 OR 6.42, p = 0.001) and molecular response consistently across all time points (week 24 OR 27.94, p < 0.001). Conclusion: NLR half reduction is a simple, cost-effective biomarker that may reflect molecular response and treatment efficacy in PV.

Original language	English
Journal	Therapeutic Advances in Hematology
Volume	17
DOIs	https://doi.org/10.1177/20406207261431904
State	Published - 1 Jan 2026

Bibliographical note

Publisher Copyright:
© The Author(s), 2026. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).

Keywords

molecular response
neutrophil-to-lymphocyte ratio
polycythemia vera
ropeginterferon alfa-2b

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Yoon, S. Y., Yoon, S. S., Yang, D. H., Lee, G. W., Sohn, S. K., Shin, H. J., Bae, S. H., Choi, C. W., Choi, E. J., Cheong, J. W., Bang, S. M., Park, J. S., Park, Y., Park, Y. H., & Lee, S. E. (2026). Neutrophil-to-lymphocyte ratio half reduction as a surrogate of molecular response in polycythemia vera treated with ropeginterferon alfa-2b. Therapeutic Advances in Hematology, 17. https://doi.org/10.1177/20406207261431904

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title = "Neutrophil-to-lymphocyte ratio half reduction as a surrogate of molecular response in polycythemia vera treated with ropeginterferon alfa-2b",

abstract = "Background: Polycythemia vera (PV) is a myeloproliferative neoplasm driven by JAK2 V617F mutations. Ropeginterferon alfa-2b effectively reduces both hematologic parameters and JAK2 allele burden, but molecular monitoring is not always readily available. Objectives: To evaluate whether a ⩾50\% reduction in the neutrophil-to-lymphocyte ratio (NLR) can serve as a surrogate marker of hematologic and molecular response during ropeginterferon therapy. Design: Secondary analysis of a multicenter, phase II, open-label trial in South Korea. Methods: Ninety-five patients with PV received ropeginterferon alfa-2b biweekly for 48 weeks. NLR and JAK2 allele burden were serially measured, and generalized estimating equations and logistic regression were used to assess associations. Results: NLR half reduction significantly predicted hematologic response (week 24 OR 6.42, p = 0.001) and molecular response consistently across all time points (week 24 OR 27.94, p < 0.001). Conclusion: NLR half reduction is a simple, cost-effective biomarker that may reflect molecular response and treatment efficacy in PV.",

keywords = "molecular response, neutrophil-to-lymphocyte ratio, polycythemia vera, ropeginterferon alfa-2b",

author = "Yoon, \{Seug Yun\} and Yoon, \{Sung Soo\} and Yang, \{Deok Hwan\} and Lee, \{Gyeong Won\} and Sohn, \{Sang Kyun\} and Shin, \{Ho Jin\} and Bae, \{Sung Hwa\} and Choi, \{Chul Won\} and Choi, \{Eun Ji\} and Cheong, \{June Won\} and Bang, \{Soo Mee\} and Park, \{Joon Seong\} and Yong Park and Park, \{Young Hoon\} and Lee, \{Sung Eun\}",

note = "Publisher Copyright: {\textcopyright} The Author(s), 2026. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).",

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month = jan,

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doi = "10.1177/20406207261431904",

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Yoon, SY, Yoon, SS, Yang, DH, Lee, GW, Sohn, SK, Shin, HJ, Bae, SH, Choi, CW, Choi, EJ, Cheong, JW, Bang, SM, Park, JS, Park, Y, Park, YH & Lee, SE 2026, 'Neutrophil-to-lymphocyte ratio half reduction as a surrogate of molecular response in polycythemia vera treated with ropeginterferon alfa-2b', Therapeutic Advances in Hematology, vol. 17. https://doi.org/10.1177/20406207261431904

TY - JOUR

T1 - Neutrophil-to-lymphocyte ratio half reduction as a surrogate of molecular response in polycythemia vera treated with ropeginterferon alfa-2b

AU - Yoon, Seug Yun

AU - Yoon, Sung Soo

AU - Yang, Deok Hwan

AU - Lee, Gyeong Won

AU - Sohn, Sang Kyun

AU - Shin, Ho Jin

AU - Bae, Sung Hwa

AU - Choi, Chul Won

AU - Choi, Eun Ji

AU - Cheong, June Won

AU - Bang, Soo Mee

AU - Park, Joon Seong

AU - Park, Yong

AU - Park, Young Hoon

AU - Lee, Sung Eun

N1 - Publisher Copyright: © The Author(s), 2026. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).

PY - 2026/1/1

Y1 - 2026/1/1

N2 - Background: Polycythemia vera (PV) is a myeloproliferative neoplasm driven by JAK2 V617F mutations. Ropeginterferon alfa-2b effectively reduces both hematologic parameters and JAK2 allele burden, but molecular monitoring is not always readily available. Objectives: To evaluate whether a ⩾50% reduction in the neutrophil-to-lymphocyte ratio (NLR) can serve as a surrogate marker of hematologic and molecular response during ropeginterferon therapy. Design: Secondary analysis of a multicenter, phase II, open-label trial in South Korea. Methods: Ninety-five patients with PV received ropeginterferon alfa-2b biweekly for 48 weeks. NLR and JAK2 allele burden were serially measured, and generalized estimating equations and logistic regression were used to assess associations. Results: NLR half reduction significantly predicted hematologic response (week 24 OR 6.42, p = 0.001) and molecular response consistently across all time points (week 24 OR 27.94, p < 0.001). Conclusion: NLR half reduction is a simple, cost-effective biomarker that may reflect molecular response and treatment efficacy in PV.

AB - Background: Polycythemia vera (PV) is a myeloproliferative neoplasm driven by JAK2 V617F mutations. Ropeginterferon alfa-2b effectively reduces both hematologic parameters and JAK2 allele burden, but molecular monitoring is not always readily available. Objectives: To evaluate whether a ⩾50% reduction in the neutrophil-to-lymphocyte ratio (NLR) can serve as a surrogate marker of hematologic and molecular response during ropeginterferon therapy. Design: Secondary analysis of a multicenter, phase II, open-label trial in South Korea. Methods: Ninety-five patients with PV received ropeginterferon alfa-2b biweekly for 48 weeks. NLR and JAK2 allele burden were serially measured, and generalized estimating equations and logistic regression were used to assess associations. Results: NLR half reduction significantly predicted hematologic response (week 24 OR 6.42, p = 0.001) and molecular response consistently across all time points (week 24 OR 27.94, p < 0.001). Conclusion: NLR half reduction is a simple, cost-effective biomarker that may reflect molecular response and treatment efficacy in PV.

KW - molecular response

KW - neutrophil-to-lymphocyte ratio

KW - polycythemia vera

KW - ropeginterferon alfa-2b

UR - https://www.scopus.com/pages/publications/105037883451

U2 - 10.1177/20406207261431904

DO - 10.1177/20406207261431904

M3 - Article

AN - SCOPUS:105037883451

SN - 2040-6207

VL - 17

JO - Therapeutic Advances in Hematology

JF - Therapeutic Advances in Hematology

ER -

Neutrophil-to-lymphocyte ratio half reduction as a surrogate of molecular response in polycythemia vera treated with ropeginterferon alfa-2b

Abstract

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Keywords

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