Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratio as Potential Minor Criteria for Polycythemia Vera Diagnosis
A recent retrospective study found that neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were higher in polycythemia vera (PV) than in secondary polycythemia and demonstrated stronger diagnostic value than serum levels of erythropoietin (EPO), showing their promise as minor diagnostic criteria.
“The role of inflammation in the pathophysiology of polycythemia vera is important,” Min Jung Kim, MD, and Seong Soon Kwon, MD, Soonchunhyang University Seoul Hospital, Seoul, South Korea, and co-authors wrote, “The neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are a readily available marker of inflammation. Thus, we examined whether NLR & PLR might diagnose PV in erythrocytosis patients.”
This retrospective analysis included 285 patients with erythrocytosis who underwent a test for the JAK2 mutation and were labeled as either cohort 1, the PV group, or cohort 2, the secondary polycythemia (SP) group.
Results showed the median NLR and PLR in the PV group was significantly higher than in the SP group (NLR: 6.04 vs. 1.77, PLR: 283.18 vs 101.56, respectively, P < .001). In the receiver operating characteristic analysis, the area under the curve of NLR and PLR was significantly higher than that of serum erythropoietin (EPO) (NLR vs EPO: 0.921 vs. 0.827, P = .003; PLR vs EPO: 0.917 vs 0.827, P = .003).
The study authors concluded, “[NLR and PLR] showed better diagnostic value than serum EPO level, highlighting their potential as minor diagnostic criteria in patients with PV.”
Source:
Kim MJ, Kwon SS, Ji YS, et al. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as new possible minor criteria for diagnosis of polycythemia vera. International Journal of Laboratory Hematology. Published online July 27, 2023. doi:10.1111/ijlh.14138
