What are the possible platelet-to-neutrophil-lymphocyte ratio variations in the context of blood donation

Answer from top 10 papers

The studies reviewed do not directly address the specific variations in the platelet-to-neutrophil-lymphocyte ratio (PNLR) in the context of blood donation. However, they provide insights into the effects of blood donation on individual components of the PNLR, such as platelet count and lymphocyte subsets. Guclu et al. (2015) reports a significant reduction in platelet count 24 hours after platelet apheresis, with no significant changes in lymphocyte subsets (Guclu et al., 2015). Awaji et al. (2021) observes transient changes in lymphocyte subsets following whole blood donation, with an increase in the neutrophil count and changes in the CD4/CD8 ratio, although these changes were not significant when adjusted for body mass index (BMI) (Awaji et al., 2021).
While these findings do not offer a direct analysis of PNLR post-blood donation, they suggest that individual components of this ratio are affected by the process. Given that platelet count decreases significantly after platelet apheresis and neutrophil count increases after whole blood donation, it is plausible to infer that PNLR may exhibit variations following blood donation. However, without specific data on the combined ratio, any conclusions must be considered speculative.
In summary, while the reviewed literature indicates that blood donation can affect platelet counts and neutrophil levels, the direct impact on PNLR is not explicitly documented. Further research would be required to determine the specific variations in PNLR resulting from blood donation (Awaji et al., 2021; Guclu et al., 2015).

Source Papers

Changes in hematological indices and lymphocyte subsets in response to whole blood donation in healthy male donors

Whole blood donation has immunomodulatory effects, and most of these have been observed at short intervals following blood donation. This study aimed to investigate the impact of whole blood donation on lymphocyte subsets over a typical inter-donation interval. Healthy male subjects were recruited to study changes in complete blood count (CBC) (n = 42) and lymphocyte subsets (n = 16) before and at four intervals up to 106 days following blood donation. Repeated measures ANOVA were used to compare quantitative variables between different visits. Following blood donation, changes in CBC and erythropoietin were as expected. The neutrophil count increased by 11.3% at 8 days (p < .001). Novel changes were observed in lymphocyte subsets as the CD4/CD8 ratio increased by 9.2% (p < .05) at 8 days and 13.7% (p < .05) at 22 days. CD16-56 cells decreased by 16.2% (p < .05) at 8 days. All the subsets had returned to baseline by 106 days. Regression analysis showed that the changes in CD16-56 cells and CD4/CD8 ratio were not significant (Wilk’s lambda = 0.15 and 0.94, respectively) when adjusted for BMI. In conclusion, following whole blood donation, there are transient changes in lymphocyte subsets. The effect of BMI on lymphocyte subsets and the effect of this immunomodulation on the immune response merit further investigation.

Open Access
The platelet-to-lymphocyte ratio versus neutrophil-to-lymphocyte ratio in prediction of COVID-19 outcome

Clinical presentation is an undependable prognostic indicator of COVID-19 (COronaVIrus Disease 2019). So, a more objective predictor is needed to precisely evaluate and classify the prognosis. Immune dysregulation to lymphocytes, mainly T-lymphocytes, have been noticed between COVID-19 patients. The aim. This study was planned to determine the role of platelet-to-lymphocyte count ratio and neutrophil-to-lymphocyte ratio in assessment of COVID-19 prognosis. Methods. 70 hospitalized patients with confirmed COVID-19 were included in this study. All included patients underwent a consistent clinical, radiological and blood examination. Laboratory analysis was made by means of a commercially accessible kit. Blood cells ratios were computed by dividing their absolute counts. Results. Non-significant association was found between laboratory data and COVID-19 clinical severity. A significant association between CT classification and platelet-to-lymphocyte count ratio (higher value in L type; p = 0.001) was detected. Platelet-to-lymphocyte count ratio was significantly higher among intubated cases. However, Non-significant association was found between neutrophil-to-lymphocyte ratio and need of endotracheal intubation. Conclusion. Routine blood values are abnormal in patients with COVID-19. Platelet-to-lymphocyte count ratio ratios could be used as more meaningful biomarker than other values in predicting the prognosis of COVID-19. LMR helpful in COVID-19 severity.

Prognostic Relevance of Pretreatment Peripheral Neutrophil Count and Neutrophil-to-lymphocyte Ratio in Primary Cutaneous Angiosarcoma.

Systemic inflammatory response markers, including neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and monocyte-to-lymphocyte ratio, are useful prognostic factors for various malignant tumours. The aim of this study was to investigate the clinical relevance of these markers in primary cutaneous angiosarcoma. Twenty-six patients were retrospectively divided into 2 groups according to pretreatment peripheral blood cell counts or systemic inflammatory response marker levels; overall survival and progression-free survival were compared. Univariate analysis found that high neutrophil count (> 3.1×109/l), high neutrophil-to-lymphocyte ratio (> 2.4), high platelet-to-lymphocyte ratio (> 175) and low lymphocyte count (≤ 1.3×109/l) were related to shorter overall survival, while high neutrophil and low lymphocyte groups had shorter progression-free survival. In multivariate analysis, high neutrophil count and high neutrophil-to-lymphocyte ratio (hazard ratio 7.44 and 5.04, 95% confidence interval 1.48–37.2 and 1.26–20.1, respectively) were identified as independent prognostic factors for poor overall survival. These results indicate that systemic inflammatory response markers serve as prognostic predictors in primary cutaneous angiosarcoma, as well as in other types of soft-tissue sarcoma.

Open Access
The predictive role of neutrophil-lymphocyte ratio, platelet lymphocyte ratio, and other complete blood count parameters in eclampsia and HELLP syndrome

Background/Aim: Previous studies declared the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, and other routine complete blood count (CBC) components as sensitive preeclampsia biomarkers. We speculated that the same associations existed with eclampsia and HELLP syndrome. Methods: This retrospective case-control study was conducted on 120 pregnant women between the ages of 18 and 40 years. Forty-nine patients with HELLP syndrome, 40 patients with eclampsia/preeclampsia, and 40 healthy pregnant women were included in the study. All groups were evaluated in terms of clinical characteristics and first-trimester hematological parameters. The primary outcomes were neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and the secondary results were hemoglobin, red blood distribution width, mean platelet volume, platelet count, neutrophil count, and lymphocyte count. Results: The median gestational age was 34 weeks (ranging between 23 and 41), with a median birth weight of 2300 grams. The median NLR was 3.9 (1.3-25.1), and the median PLR was 113.6 (20.7-693). The NLR and PLR values were significantly different between the three groups (P=0.014, P=0.002, respectively). NLR was different between normotensive and eclamptic pregnant women. PLR values were higher in normotensive pregnant women than in pregnant women with a history of HELLP. The median red cell distribution width was 44.6 in normotensive women, 41.5 in women with eclampsia, and 44.3 in women with a history of HELLP (P=0.017). Conclusion: TLR value was higher in pregnant women who had eclampsia. Platelet count and MPV were significantly lower in the HELLP group.

Open Access
Evaluation of Neutrophil to Lymphocyte Ratio and Mean Platelet Volume in Inactive Hepatitis B Carriers

Aim: The aim of this study was to investigate the neutrophil to lymphocyte ratio (NLR) and mean platelet volume (MPV) levels in children with inactive hepatitis B virus (HBV) carriers and to evaluate the possible association between NLR, MPV and inflammation status in HBV infection. Material and Method: Thirty inactive HBV carrier children and 32 age and gender matched healthy controls were enrolled as study group. Complete blood count parameters including white blood count, absolute neutrophil count and lymphocyte count, neutrophil to lymphocyte ratio and mean platelet volume were assessed in both study and the control groups. Results: There was no significant difference in the mean age of inactive HBV carriers (11.9±3.4 years) and the control subjects (11.0±2.7 years) (p=0.25). No significant differences were found in NLR (2.90±3.24 and 1.74±0.87, respectively, p=0.82) and MPV levels (7.9±1.0fL and 8.0±1.2fL, respectively, p=0.86) between inactive HBV carriers and the controls. MPV was found to be inversely correlated with platelet count in both patients and the control groups (r=-0.44, p=0.01; r=-0.36, p=0.04, respectively). A positive correlation was found between NLR and MPV (r=0.41, p=0.03) in patient group. Conclusion: NLR and MPV levels were not different in inactive HBV carrier children compared to the controls. Our results suggest that NLR and MPV values may not be appropriate for determining of chronicity and inflammation status in chronic HBV infection. Key words: Hepatitis B, chronic, neutrophil to lymphocyte ratio, mean platelet volume

Open Access
Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Routine Complete Blood Count Components in HELLP Syndrome: A Matched Case Control Study.

Background and objective: Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are new readily available inflammatory markers that have been analyzed in pregnancy-induced hypertensive disorders such as preeclampsia. Studies on the NLR/PLR ratio in hemolysis, elevated liver enzymes, low-platelet count (HELLP) syndrome are limited in the current literature. We compared NLR/PLR and other complete blood count (CBC) components between women with HELLP syndrome and women with healthy pregnancies. Methods: We conducted a retrospective matched case–control study at a tertiary care hospital in NY (USA) in the time frame between January 2016 and December 2018. The study compared pregnant women with HELLP syndrome (cases) to women with healthy pregnancies in the third trimester (controls), matched by age, body mass index (BMI), parity, and race. Patient with preeclampsia, infection, and fever were excluded. Venous blood samples were obtained as part of the routine work-up at admission for delivery, which included a CBC. The main outcomes were NLR and PLR. The secondary outcomes were hemoglobin, red cell distribution width (RDW), platelet count, mean platelet volume (MPV), neutrophils, lymphocytes. Results: There were 14 patients in each group. They were matched by age, race, BMI, and parity. NLR (5.8 vs. 3.6, p-value = 0.002) and neutrophil count (10.7 vs. 6.8, p-value = 0.001) were higher in women with HELLP compared to controls. PLR (34 vs. 130.2, p-value < 0.001) and platelet count (71 vs. 223, p-value < 0.001) were lower in the study group compared to controls. Conclusions: NLR was higher, and PLR was lower in women with HELLP syndrome. These inflammatory markers can be incorporated into the diagnostic algorithm for HELLP syndrome. Future studies are needed to evaluate their ability to predict HELLP syndrome.

Open Access
Changes in Hematological Indices and Lymphocyte Subsets in Response to Platelet Apheresis Donation.

Platelet apheresis is a technique in which whole blood is collected from a donor followed by platelet (PLT) separation. Platelet apheresis has a significant impact on some biochemical indices after donation. This study aimed to investigate the impact of platelet apheresis on complete blood count (CBC) and lymphocyte subsets over a typical interdonation interval. Healthy male subjects (n = 10) were recruited to study changes in CBC and lymphocyte subsets before and at three intervals following platelet apheresis. Repeated measures ANOVA was used to compare quantitative variables between different visits. Following platelet apheresis, platelet count decreased 30% at 24 hours after donation (p < 0.001) compared to the baseline count with significant repeated ANOVA across different visits (p < 0.001, Eta = 0.558). No changes were observed in other variables of CBC. The lymphocyte subsets including CD4, CD8, and CD4/CD8 ratio were decreased at 24 hours after donation (-0.6%, -0.4% and -0.7%, respectively) but none was significant. At 24 hours, the proportion of CD19 and CD16-56 were slightly increased (1.6%, 3.3%, p > 0.05, respectively). The significant reduction in PLT count after 24 hours of plateletpheresis may have adverse health effects on PLT donors. Platelet apheresis has no significant effect on lymphocyte subsets of the donor.