Blood cells ratios and assessment of asthmatic children who stopped omalizumab.

<bold>Background:</bold> Alongside the evaluation of absolute concentrations of blood cell types, neutrophil-to-lymphocyte ratio (NLR), eosinophil-to-lymphocyte ratio (ELR) and platelet-to-lymphocyte ratio (PLR) were suggested as biomarkers for monitoring and predicting morbidity and mortality of several inflammatory diseases, such as asthma. <bold>Objective:</bold> To assess the impact of NLR, ELR and PLR on the management of asthmatic pediatric subjects who stopped treatment with omalizumab. <bold>Methods:</bold> We retrospectively collected data on the number of exacerbations, courses of systemic steroids, asthma control test (ACT) score, blood count ratios, and respiratory function (FEV1%). The analysis was conducted at baseline (T0), at 18 months of therapy (T1) and one year after the suspension (T2). <bold>Results:</bold> 9 subjects (33% female), with a mean duration of treatment with omalizumab of 2.1 ± 0.9 years, were included in the final analysis. Statistical analysis revealed significant correlations in the number of exacerbations (<italic>p</italic>. 036 and. 025), courses of systemic steroids (<italic>p</italic>. 000 and. 048), ACT score (<italic>p</italic>. 000 and. 013), and FEV1% (<italic>p</italic>. 005 and. 012) at T0 and T1 and T1 and T2, respectively. No significant difference was observed in NLR (<italic>p</italic>. 454 and. 787), ELR (<italic>p</italic>. 632 and. 714) and PLR (<italic>p</italic>. 470 and. 754) throughout the study duration. <bold>Conclusion:</bold> Despite the maintenance of efficacy one year after the suspension of omalizumab in terms of the number of annual exacerbations, courses of systemic steroids, ACT, and FEV1%, our data did not support NLR, ELR and PLR as potential predictors of omalizumab effectiveness. Further studies, including a larger sample size, are necessary.