Necessity of neutrophil-to-lymphocyte ratio monitoring for hypothyroidism using nivolumab in patients with cancer

Figure 4 Relationship between neutrophil-to-lymphocyte ratio and the onset period of hypothyroidism. The median onset periods of each group with maximum neutrophil-to-lymphocyte ratio (NLR) values of < 3.5, 3.5 to < 5, and ≥ 5 were at 5^th (n = 7), 6^th (n = 5), and 9^th administration (n = 9), respectively. The groups with a maximum NLR of < 3.5 had a significantly earlier onset of hypothyroidism than the group with NLR ≥ 5, whereas there was no significant difference in the onset periods of the groups with maximum NLR values of 3.5-5 and ≥ 5 (HR for low tertile compared with highest tertile: 5.33; 95%CI: 1.47-19.33, P = 0.011; HR for middle tertile compared with highest tertile: 3.15; 95%CI: 0.83-11.89, P = 0.091).