PERIPHERIAL BLOOD BIOMARKERS IN PATIENTS WITH REFRACTORY IMMUNE THROMBOCYTOPENIA

Area of Science:

• Hematology
• Immunology
• Oncology

Background:

• Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by autoantibodies against platelet antigens, leading to thrombocytopenia.
• The precise pathogenesis of ITP remains incompletely understood, with limited evidence on inflammatory factors in treatment-refractory cases.

Purpose of the Study:

• To investigate the diagnostic value of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), platelet-to-monocyte ratio (PMR), derived NLR (dNLR), and systemic immune-inflammation index (SII) in ITP patients.
• To assess these inflammatory biomarkers in patients refractory to first-line treatment and undergoing splenectomy as second-line therapy.

Main Methods:

• Statistical analyses of inflammatory biomarkers were conducted using SPSS v.26 and Graph Pad Prism.
• Correlations between variables were determined using Spearman's correlation coefficient.
• Receiver operating characteristic (ROC) curve analysis was employed to compare the area under the curve (AUC), sensitivity, specificity, and cut-off values.

Main Results:

• NLR and dNLR were significantly increased (p<0.0001), while SII (p=0.0003), PMR, and PLR (p<0.0001) were significantly decreased in ITP patients compared to age-matched controls.
• Platelet (PLT) levels showed a negative correlation with NLR and dNLR (r=-0.605, P<0.01) and a positive correlation with SII, PLR, and PMR (SII r=0.799; PLR r=0.863; PMR r=0.40, P<0.01).
• ROC curve analysis indicated high diagnostic potential for PLR (AUC=1.000, P=0.05) and PMR (AUC=1.000, P<0.001), followed by SII (AUC=0.899, P=0.002), NLR (AUC=0.875, P=0.04), and dNLR (AUC=0.869, P=0.05).

Conclusions:

• Inflammatory factor profiles significantly differ between ITP patients and age-matched controls.
• Biomarkers such as PLR, PMR, SII, NLR, and dNLR demonstrate potential diagnostic value in ITP, particularly in refractory cases.
• Larger-scale research is warranted to confirm the validity and clinical utility of these inflammatory biomarkers in ITP management.