The relationship between platelet/lymphocyte and neutrophil/lymphocyte ratios and corticosteroid treatment response in patients with newly diagnosed immune thrombocytopenia

Introduction and Aim: Immune thrombocytopenia is an autoimmune disease that can affect quality of life or lead to life-threatening bleeding. First-line treatment is important to keep the patient's platelet values within the safe range and to prevent bleeding. In our study, it was aimed to investigate the effect of NLO and PLO values, which are accepted as markers of inflammation and prognosis in many diseases, on corticosteroid therapy, which is the first-line treatment option in IT. Materials and method: In this study, patients were included between 01.01.2011 and 01.01.2022, Zonguldak Bülent Ecevit University Health Application and Research Center, Adult Hematology Department outpatient clinic and services, over the age of 18, who have not been treated in another center before, and as initial treatment in our center. The files of 114 patients with Primary Immune Thrombocytopenia who were treated with steroids were reviewed retrospectively. Demographic data, clinical features, response to steroid treatment, and NLR and TLR values of the patients were recorded. Results: 114 IT patients were included in the study. Of the patients, 75 (65.8%) were female and 39 (34.2%) were male. The mean age of the patients was 57.48±18.50 years. When the diagnosis period of the patients is examined, it is seen that 57% of them are chronic, 33.3% are in remission, 2.6% are persistent, and 7% are new. When the treatment responses of the patients were examined, 40.4% were refractory, 15.8% were corticosteroid dependent-non-responder, 35.1% were remission-responsive, 1.8% had initial response, 3.5% were sustained. response, and 3.5% were found to be early response. The mean Leukocyte values of the patients were 8711.40±3752.07; The mean neutrophil values were 6038.71±3387.01; The mean lymphocyte values were 1943.86±995.57; The mean platelet values were 15657.89±12691.60; The mean platelet/lymphocyte ratios were 10.37±11.21; Neutrophil/Lymphocyte ratios were found to be on average 4.86±7.82. In the regression analysis, it is seen that as the lymphocyte value decreases, the probability of being responsive to treatment is higher than the probability of being unresponsive to treatment. (p<0.05). Conclusion: In our study, no correlation was found between NLR and PLR rates and response to steroid treatment; a positive correlation was found between low lymphocyte levels and response to steroid treatment. We think that lymphocyte levels can be a simple and cost-effective parameter that can be widely used in predicting the response to steroid therapy, which is a first-line therapy, in patients with previously untreated disease-diagnosed IT.