Neutrophil-to-Lymphocyte Ratio (NLR)

Basis: Inflammation is often associated with a neutrophilia. Depressed immune function is associated with a lymphopenia.

Parameters:

(1) absolute neutrophil count

(2) absolute lymphocyte count

NLR =

= (absolute neutrophil count) / (absolute lymphocyte count)

Interpretation:

• A high level of inflammation is associated with an elevated NLR.

• An elevated NLR is associated with a worse prognosis.

• A cutoff for patients with IVIG resistance in Kawasaki Disease is NLR >= 3.83.

• For solid cancer an NLR >= 4 is considered elevated.

Limitations:

• Chemotherapy can cause cytopenias.