• Novel NLR, PLR and HPR biomarkers for Diagnoses of Acute lymphoblastic leukemia
  • Mohammad Reza Javan,1,* bahar moghimian,2 Seyyede Fatemeh Shams,3 Mehrnaz Abdolalian,4
    1. Blood Transfusion Research Center, High Institute for Research and Education in transfusion Medicine, Tehran, Iran.
    2. Thalassemia & Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
    3. Blood Transfusion Research Center, High Institute for Research and Education in transfusion Medicine, Tehran, Iran.
    4. Blood Transfusion Research Center, High Institute for Research and Education in transfusion Medicine, Tehran, Iran.


  • Introduction: Acute lymphoblastic leukemia (ALL) can affect both B and T cell lines at any stage of hematopoiesis. It is the most common leukemia in children and the second most common cancer in childhood. Genetic mutations in ALL cause uncontrolled cell proliferation and prevent normal cell differentiation, which can lead to death if left untreated. Therefore, timely diagnosis and treatment is very important. Complete blood count (CBC) can be a simple but valuable initial test to diagnose ALL.
  • Methods: In this study, 54 ALL patients (Mean ages: 5.29) and 29 healthy controls (Mean ages: 5.53) were evaluated and compared in terms of hematological parameters including Platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR) and hemoglobin to platelet ratio (HPR). Cytogenetics and immunophenotyping were analyzed between two groups.
  • Results: In the analysis of hematological factors between the case and control groups, all indices except Lymphocytes showed a statistically significant relationship (P-Value˂0.05). In the analysis of hematological factors between the B-ALL and T-ALL groups, only WBC and ESR showed a statistically significant relationship (P-Value˂0.05). The ROC curve was generated to select the appropriate cutoff values for NLR, PLR and HPR based on analysis. NLR and PLR has a cut off value 0.50 and 62.24 respectively and can be a good biomarker for distinguishing ALL from normal people. HPR value was significant between case and control groups, but it was not a suitable biomarker for distinguishing patients from the control group based on ROC analysis.
  • 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 diagnosis.
  • Keywords: Acute lymphoblastic leukemia, Platelet to lymphocyte ratio, Neutrophil to lymphocyte, CBC