PERIPHERIAL BLOOD BIOMARKERS IN PATIENTS WITH REFRACTORY IMMUNE THROMBOCYTOPENIA

Immune thrombocytopenia is an acquired thrombocytopenia caused by autoantibodies against platelet antigens, the pathogenesis of ITP is incompletely understood. Evidence regarding association between inflammatory factors in patients with ITP who are refractory to first line treatment is limited.The purpose of our study was to investigate the diagnostic value of NLR, PLR, and PMR, dNLR, and SII in ITP patients who were refractory for the first line treatment and had splenectomy as a second-line therapy. Statistical analyses of inflammatory biomarkers were performed using SPSS v.26 and Graph Pad Prism. Correlations between the variables were determined by Spearman's correlation coefficient. The area under the curve (AUC), sensitivity, specificity, and cut-off values were compared using the receiver operating characteristic (ROC) curve. Our data revealed that NLR and dNLR were increased (p<0.0001), while SII level was decreased (p=0.0003), PMR and PLR were also significantly low (p<0.0001) in ITP patients compared with the age matched conrl group. In addition PLT level was negatively correlated with NLR and dNLR (r=-0.605, P<0.01), while there was positive correlation with SII, PLR, PMR (SII r=0.799; PLR r=0.863; PMR r=0.40, P<0.01). ROC curve analysis revealed ACU of PLR and PMR were 1.000 (P=0.05 and P<0.001), followed by SII 0.899 (P=0.002), NLR 0.875 (P=0.04) and dNLR 0.869 (P=0.05). We observed that inflammatory factors in ITP patients significantly differ from the age matched controls, however larger scale research is needed to confirm the validity of such biomarkers.