Perbandingan Rasio Netrofil Limfosit dan Rasio Platelet Limfosit Pada Pasien Anak dengan Leukimia Limfoblastik Akut Sebelum dan Sesudah Kemoterapi Fase Induksi

Abstract

ABSTRACT

Background: Acute Lymphoblastic Leukemia (ALL) is the most common hematologic malignancy in children. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are simple inflammatory biomarkers that may serve as prognostic and therapeutic response indicators. Objective: To evaluate the differences in NLR and PLR before and after induction chemotherapy and to determine optimal cut-off values for predicting treatment response in pediatric ALL patients. Methods: An observational analytic study with a retrospective design was conducted on 48 pediatric ALL patients at Adam Malik General Hospital, Medan. The Wilcoxon test was applied to assess differences in NLR and PLR, while ROC analysis was used to determine cut-off values, sensitivity, and specificity. Results: Most patients were under 10 years of age (66.7%) and male (58.3%). Following induction chemotherapy, 87.5% achieved complete remission. Significant differences in NLR and PLR were observed before and after therapy (p<0,001). The optimal cut-off for NLR was 2.33 (sensitivity 45.2%, specificity 83.3%), while for PLR it was 219.98 (sensitivity 42.9%, specificity 83.3%). Conclusion: NLR and PLR significantly changed after induction chemotherapy in pediatric ALL patients. Despite limited sensitivity, both markers may serve as simple hematological tools for evaluating treatment response

Keywords: Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, Induction Phase Chemotherapy