Platelet to Neutrophil Ratio as a Novel Marker for Monitoring SCD Patients on Hydroxyurea

Abstract Presentation Date: 6/9/2024 Presentation Start Time: 4:15:00 PM Background Sickle cell disease (SCD) is an inherited hemolytic anemia, common in developing countries like Nigeria. Platelet to neutrophil ratio is an inflammatory marker used to determine outcome in some disease conditions. Developing a simple but effective means of monitoring SCD patients on hydroxyurea may be beneficial to the developing world, where poverty makes it difficult to adequately manage and follow up SCD patients. Methods This was a retrospective study whose data was obtained from the Children’s National Hospital Washington DC, USA medical records for 347 SCD patients as part of the CNH Natural History Study of SCD. Statistical analyses were employed to evaluate the association between the platelet-neutrophil ratio(PNR) and hydroxyurea intake. Descriptive, Univariate and Multivariate analyses were performed. P value 0.05 was statistically significant. Results A total of 347 patient records were studied of which 176(50.7) were males and 171(49.3) were females. Hemoglobin SS patients on hydroxyurea were found to have higher hemoglobin concentration and platelet count, though not statistically significant. P = 0.478, 0.52) but had lower WBC, Reticulocyte count, neutrophil count and higher PNR when compared to those not on hydroxyurea. (p = 0.00,0.00,0.00, 0.006) respectively. This contrast with HbSC and other genotype with no statistically significant association of the named parameters. PNR was highest amongst HbSS patients on hydroxyurea 83.6 (58.1-115.3 (p = 0.006). unlike Hb SC patient. p = 0.805. multivariate analysis, showed PNR to be the only variable influencing hydroxyurea use(p = 0.0009) Conclusions Platelet to neutrophil ratio has been found to be an effective metric for assessing HbSS patients on HU. We recommend further studies to calculate the expected normal range of PNR for SCD patients of all ages, gender as well as determine values below which different SCD complications may occur. This will allow for development of reference intervals of PNR for more effective patient management in resource poor countries. Larger studies are needed to validate these findings.