Mustafa Selçuk AYAR, Alper YAŞAR, Fatih ÇALIŞKAN, Engin KELKİTLİ
European Journal of Therapeutics - 2026;32(3):271-280
Objective: Pancytopenia, characterized by reductions in all three blood cell lines, often indicates underlying bone marrow or peripheral cell line diseases. This study evaluates the neutrophil-to-lymphocyte ratio (NLR) and ferritin levels as predictors of hematologic malignancy among cytopenic patients presenting to the emergency department. Methods: A retrospective study was conducted on 236 cytopenic patients admitted to the Emergency Department at Ondokuz Mayıs University Hospital from January 1, 2023, to January 1, 2024. Inclusion criteria were patients aged 18 years or older with cytopenia; exclusions included patients younger than 18 years or those with known non-hematologic malignancies. Causes of cytopenia were categorized into non-hematologic malignancy (Group 1, n = 182) and hematologic malignancy (Group 2, n = 54). Demographic data and laboratory parameters were recorded and analyzed. Results: Patients with hematologic malignancy had significantly lower white blood cell (WBC) and neutrophil counts, but higher lymphocyte counts and ferritin levels. The NLR was notably lower in the hematologic malignancy group compared to the non-malignancy group. ROC analysis identified NLR (AUC 0.846, cut-off <= 1.65) and ferritin (AUC 0.738, cut-off >= 407.2) as strong predictors of hematologic malignancy. Logistic regression indicated that decreasing NLR increased the likelihood of hematologic malignancy (OR 0.429, 95% CI: 0.294-0.624, p < 0.001). Conclusion: NLR and ferritin are accessible and effective predictors of hematologic malignancy in cytopenic patients in emergency settings. Further prospective studies are necessary to validate these findings against advanced diagnostic tests.
