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Neutrophil-to-lymphocyte and Platelet-to-lymphocyte Ratios in Pediatric Sickle Cell Disease: Association with Vaso-occlusive Crises and Treatment Modalities
Journal article   Open access   Peer reviewed

Neutrophil-to-lymphocyte and Platelet-to-lymphocyte Ratios in Pediatric Sickle Cell Disease: Association with Vaso-occlusive Crises and Treatment Modalities

Jessica Zon, Jeffrey Hernandez, Michael Zon and Nataly Apollonsky
The journal of pediatric research, v 13(2), pp 158-162
01 Jul 2026
DOI: https://doi.org/10.4274/jpr.galenos.2026.22457
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url
https://doi.org/10.4274/jpr.galenos.2026.22457View
Published, Version of Record (VoR) Open

Abstract

neutrophil-lymphocyte ratio Platelet-lymphocyte ratio sickle cell disease vaso-occlusive crisis
<p>Platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) are emerging markers for inflammation. In sickle cell disease (SCD), inflammation is a central feature of vaso-occlusive crises (VOC). This study evaluated NLR and PLR dynamics in pediatric SCD patients during VOC and it examined the impacts of treatments such as hydroxyurea and chronic transfusion therapy on these markers. This cross-sectional study included 100 SCD patients aged 2-27 years presenting for VOC. Paired t-tests and ANOVA were used to compare VOC and steady-state values with p<0.05 considered statistically significant. Total white blood cell count, absolute neutrophil count, and NLR were significantly elevated during VOC. Platelet counts were significantly higher during steady state in untreated patients, but no significant differences were observed in PLR. In treated patients, platelet counts remained elevated both at steady state and during VOC. No significant differences in NLR or PLR were found between the treatment groups. These findings support NLR as a sensitive marker of inflammation during VOC in pediatric SCD patients. However, treatment modalities such as hydroxyurea and chronic transfusions may not significantly impact NLR and PLR levels. Larger, prospective studies are needed to further define their roles in disease monitoring.</p>

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