NLR, PLR, and HPR as novel diagnostic biomarkers for Acute Lymphoblastic Leukemia

Moghimian, Bahareh and Jafari-joshaghan, Ahmad and Ayatollahi, Hossein and Shams, Fatemeh and Soltani, Narjes and Ahmadpour, Fatemeh (2023) NLR, PLR, and HPR as novel diagnostic biomarkers for Acute Lymphoblastic Leukemia. Iranian Journal of Blood and Cancer.

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Abstract

Background: Acute lymphoblastic leukemia (ALL) causes uncontrolled cell proliferation and prevents normal cell differentiation at any stage of hematopoiesis. Therefore, timely diagnosis and treatment are very important. Complete blood count (CBC) can be a simple, but valuable initial test to diagnose ALL. In this study, we investigated the diagnostic value of hematological parameters, including Platelet to lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and hemoglobin to Platelet ratio (HPR) indices in ALL. Methods: In this study, 54 ALL patients (Mean ages: 5.29) and 58 healthy controls (Mean ages: 5.53) were evaluated. They were compared in terms of hematological parameters, including PLR, NLR, and HPR; cytogenetic and immunophenotypes were also analyzed. Result: In the analysis of hematological factors between the studied groups, all indices except lymphocytes showed a statistically significant relationship (P-Value ˂0.05). In terms of hematological factors, only WBC and ESR were statistically significant between the B-ALL and T-ALL groups (P-Value ˂0.05). The ROC curve was generated to select the appropriate cut-off values for NLR, PLR, and HPR based on analysis. NLR and PLR have cut-off values of 0.50 and 62.24, respectively; they are good biomarkers to distinguish ALL individuals from normal people. HPR value was significant between case and control groups, but it was not a suitable indicator for distinguishing patients from the control group. Conclusion: CBC is a simple and valuable test for early detection of ALL, and the new PLR and NLR markers are good hematologic markers for ALL diagnoses.

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