Pattern of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in sickle cell anemia patients at steady state and vaso-occlusive crisis

Abstract

BACKGROUND: Neutrophil-lymphocyte ratio (NLR) and Platelet-Lymphocyte ratio (PLR) are emerging markers of systemic inflammation in chronic disorders, including hemoglobinopathies. OBJECTIVE: This study determined the pattern of NLR and PLR in sickle cell anemia (SCA) patients during steady state and vasoocclusive crisis (VOC). MATERIALS AND METHODS: A cross-sectional study composed of 60 adult SCA patients (30 during VOC and 30 during steady state). Thirty apparently healthy hemoglobin A (HbA) age- and sex-matched controls were included in the study. Complete blood count (CBC) was done for each participant; NLR was calculated as absolute neutrophil count (ANC) divided by the absolute lymphocyte count (ALC), and PLR was calculated as platelet count divided by ALC. STATISTICAL ANALYSIS: Data were analyzed using SPSS (version 22), and the results were considered statistically significant if value of P RESULTS: Total white-cell count, ANC, ALC, platelet count, and NLR were significantly higher in SCA patients than those of HbA controls. Total white-cell count, ANC, and NLR were significantly higher in the VOC than the steady-state group. PLR was not statistically different between the steady state and the VOC groups. In both groups of SCA patients, NLR was positively correlated with PLR, while percentage fetal hemoglobin was negatively correlated with percentage hemoglobin S. Hematocrit was negatively correlated with ANC and ALC in SCA patients. CONCLUSION: This study showed a significantly higher NLR and PLR in SCA than the control group. These are reflective of the roles of neutrophils, platelets, and lymphocytes in the constitutive inflammatory process. These ratios could be adopted for use in SCA patients because these markers are cheap, stable, and easily derivable from CBC.