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Journals / Kocatepe Tıp Dergisi / 2025 / Cilt: 26 Sayı: 4

PROGNOSTIC VALUE OF NEUTROPHIL/LYMPHOCYTE RATIO, PLATELET/LYMPHOCYTE RATIO, SYSTEMIC IMMUNE-INFLAMMATION INDEX, AND MEAN PLATELET VOLUME-RELATED INDICES IN PEDIATRIC ONCOLOGY PATIENTS EXPERIENCING FEBRILE NEUTROPENIA EPISODES AFTER CHEMOTHERAPY

KEMOTERAPİ SONRASI FEBRİL NÖTROPENİ ATAĞI GEÇİREN PEDİATRİK ONKOLOJİ HASTALARINDA NÖTROFİL/LENFOSİT ORANI, PLATELET/LENFOSİT ORANI, SİSTEMİK İMMÜN-İNFLAMASYON İNDEKSİ VE ORTALAMA TROMBOSİT HACMİYLE İLİŞKİLİ İNDEKSLERİN DEĞERLENDİRİLMESİ

Arzu Keskin Aktan(AFYONKARAHİSAR SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, TIP FAKÜLTESİ, TEMEL TIP BİLİMLERİ BÖLÜMÜ, FİZYOLOJİ ANABİLİM DALI)0000-0002-2878-0841
İbrahim Eker(AFYONKARAHİSAR SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, TIP FAKÜLTESİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, ÇOCUK SAĞLIĞI VE HASTALIKLARI ANABİLİM DALI, ÇOCUK HEMATOLOJİ BİLİM DALI)0000-0002-1880-546X
Fatma Nur Üstün(AFYONKARAHİSAR SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, TIP FAKÜLTESİ, TIP PR.)0009-0009-0839-3439
Ali İhsan Karaman(AFYONKARAHİSAR SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, TIP FAKÜLTESİ, TIP PR.)0009-0001-7089-8739
Ahmet Eren Çağıl(AFYONKARAHİSAR SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, TIP FAKÜLTESİ, TIP PR.)0009-0008-0987-7286
Buket Çam(AFYONKARAHİSAR SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, TIP FAKÜLTESİ, TIP PR.)0009-0000-8986-4830
Ece Merve Sökmen(AFYONKARAHİSAR SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, TIP FAKÜLTESİ, TIP PR.)0009-0007-5825-9081
Nilüfer Bağcı(AFYONKARAHİSAR SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, TIP FAKÜLTESİ, TIP PR.)0009-0007-9299-9059
Tuana Kepel(AFYONKARAHİSAR SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, TIP FAKÜLTESİ, TIP PR.)0009-0009-4317-9569
Pages
286–294
Publication Date
2025-10-13
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AI Summary & Key Takeaways

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CONCLUSIONS: It can be said that among the indices we investigated, the MPV/PCT is the primary variable predicting FN episodes that may occur in pediatric oncology patients following chemotherapy.

📌 3 Key Takeaways

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Objective & Hypothesis:OBJECTIVE: Febrile neutropenia (FN) is one of the most common complications of myelosuppressive chemotherapy and a significant cause of hospitalization and mortality.
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Key Findings & Data:MATERIAL AND METHODS: In a single-center, retrospective cohort study, patients aged 0-16 years receiving chemotherapy for cancer (n = 98) were divided into two groups: those who experienced an FN episode within one month following chemotherapy (n = 40) and those who did not (n = 58).
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Conclusion & Impact:CONCLUSIONS: It can be said that among the indices we investigated, the MPV/PCT is the primary variable predicting FN episodes that may occur in pediatric oncology patients following chemotherapy.
🔬Design:Modeling & Simulation
📍Scope:Comprehensive Sample
⚙️Variables:Febril nötropeni · Kanser · Kemoterapi

Abstract

OBJECTIVE: Febrile neutropenia (FN) is one of the most common complications of myelosuppressive chemotherapy and a significant cause of hospitalization and mortality. The study aimed to evaluate hematological indices, including neutrophil/ lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and mean platelet volume (MPV) related indices in the FN episodes in pediatric oncology patients receiving chemotherapy. MATERIAL AND METHODS: In a single-center, retrospective cohort study, patients aged 0-16 years receiving chemotherapy for cancer (n = 98) were divided into two groups: those who experienced an FN episode within one month following chemotherapy (n = 40) and those who did not (n = 58). Socio-demographic characteristics (age, gender), basic clinical features (reason for admission, history, diagnosis, antibiotic use, comorbidities, etc.), and hematologic findings data were recorded. Based on the patients' current hemogram data, NLR, PLR, SII, MPV/ platelet ratio (MPV/PLT), MPV/C-reactive protein ratio (MPV/ CRP), and MPV/procalcitonin ratio (MPV/PCT) were calculated. Chi-square, independent sample t-test, or Mann-Whitney U-test were used to compare groups. Logistic regression and receiver operating characteristics (ROC) analyses were also conducted. A level of P < 0.05 was considered statistically significant. RESULTS: In the FN group, NLR and SII were significantly lower whereas PLR was significantly higher. Among the MPV related indices, MPV/PLT was significantly higher in the FN group, whereas MPV/CRP and MPV/PCT were significantly lower. In the multivariate logistic regression model constructed with age, CRP, PLR, and MPV/PCT as potential predictive factors for FN, only MPV/PCT was identified as an independent predictive factor for FN. Additionally, it was observed that MPV/PCT had a sensitivity of 89.7% and a specificity of 100% for FN at the optimal cut-off value of 57.33. CONCLUSIONS: It can be said that among the indices we investigated, the MPV/PCT is the primary variable predicting FN episodes that may occur in pediatric oncology patients following chemotherapy.

Özet

AMAÇ: Febril nötropeni (FN), miyelosüpresif kemoterapinin en yaygın görülen komplikasyonlarından biridir ve önemli oranda hospitalizasyon ve mortalite nedenidir. Çalışmada kemoterapi alan pediatrik onkoloji hastalarında görülen FN atağında nötrofil/ lenfosit oranı (NLR), platelet/lenfosit oranı (PLR), sistemik immün-inflamasyon indeksi (SII) ve ortalama trombosit hacmiyle (MPV) ilişkili hematolojik indekslerin değerlendirilmesi amaçlandı. GEREÇ VE YÖNTEM: Tek merkezli, retrospektif kohort çalışmada, 0-16 yaş aralığında kanser nedeniyle kemoterapi alan hastalar (n = 98), kemoterapiden sonraki bir ay içinde FN atağı olanlar (n = 40) ve olmayanlar (n = 58) şeklinde iki gruba ayrıldı. Hastaların sosyodemografik özellikleri (yaş, cinsiyet), temel klinik özellikleri (geliş nedeni, öykü, tanı, antibiyotik kullanımı, komorbidite vb) ve hematolojik bulgularına ait veriler kaydedildi. Hastaların mevcut hemogram verileri kullanılarak NLR, PLR, SII, MPV/platelet oranı (MPV/PLT), MPV/C-reaktif protein oranı (MPV/CRP) ve MPV/prokalsitonin oranı (MPV/PCT) hesaplandı. Grupları karşılaştırmak için ki-kare, bağımsız örneklem t testi veya Mann-Whitney U testi kullanıldı. Ayrıca lojistik regresyon ve alıcı çalışma karakteristikleri (ROC) analizleri yapıldı. P < 0,05 düzeyi istatistiksel olarak anlamlı kabul edildi. BULGULAR: FN grubunda NLR ve SII anlamlı olarak düşük, PLR ise yüksek bulundu. MPV ilişkili indekslerden MPV/PLT, FN grubunda anlamlı olarak yüksek iken MPV/CRP ve MPV/PCT ise düşüktü. FN için potansiyel prediktif faktörler olarak tespit edilen yaş, CRP, PLR ve MPV/PCT ile oluşturulan çok değişkenli lojistik regresyon modelinde sadece MPV/PCT’nin FN için bağımsız prediktif faktör olduğu bulundu. Ayrıca 57,33 optimal kesme değeri için MPV/PCT’nin % 89,7 duyarlılık ve %100 özgüllüğe sahip olduğu görüldü. SONUÇ: Araştırdığımız indeksler arasında MPV/PCT’nin, pediatrik onkoloji hastalarında kemoterapi sonrasında görülebilen FN atağını yordayan başlıca değişken olduğu söylenebilir.

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Cite This Article

Aktan, A. K., Eker, İ., Üstün, F. N., Karaman, A. İ., Çağıl, A. E., Çam, B., Sökmen, E. M., Bağcı, N., Kepel, T. (2025). PROGNOSTIC VALUE OF NEUTROPHIL/LYMPHOCYTE RATIO, PLATELET/LYMPHOCYTE RATIO, SYSTEMIC IMMUNE-INFLAMMATION INDEX, AND MEAN PLATELET VOLUME-RELATED INDICES IN PEDIATRIC ONCOLOGY PATIENTS EXPERIENCING FEBRILE NEUTROPENIA EPISODES AFTER CHEMOTHERAPY. Kocatepe Tıp Dergisi, Cilt: 26 Sayı: 4, 286–294. https://doi.org/10.18229/kocatepetip.1477957

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