Calculates the derived neutrophil-to-lymphocyte ratio from total white-cell and neutrophil counts.
Overview
Calculates the derived neutrophil-to-lymphocyte ratio from total white-cell and neutrophil counts.
Clinical Significance
A surrogate inflammatory ratio used in oncology research when direct lymphocyte count is unavailable. It is not interchangeable with conventional NLR.
How It Is Calculated
- dNLR = neutrophils / (white-cell count − neutrophils).
Interpretation
- A surrogate inflammatory ratio used in oncology research when direct lymphocyte count is unavailable. It is not interchangeable with conventional NLR.
Worked Example
Enter a clinically consistent set of values in the displayed units. MedicalC applies: dNLR = neutrophils / (white-cell count − neutrophils).
Limitations
- This tool does not establish a diagnosis or mandate treatment.
- Published cut-offs may vary between cohorts and measurement methods.
- Calculation precision cannot compensate for poor source data.
Clinical Pearls
- Trend the result over time where clinically appropriate.
- Record the source values and units alongside the calculated result.
Common Mistakes
- Using the wrong unit.
- Combining measurements obtained at different times.
- Applying a research-derived threshold as a universal treatment trigger.
Frequently Asked Questions
What does this calculator provide?
Calculates the derived neutrophil-to-lymphocyte ratio from total white-cell and neutrophil counts.
Can this result be used alone?
No. It must be interpreted with clinical context and appropriate investigations.
What equation is used?
dNLR = neutrophils / (white-cell count − neutrophils).
What is the main limitation?
The result depends on valid inputs and may not be calibrated for every population or setting.
References
- Proctor MJ et al. A derived neutrophil to lymphocyte ratio predicts survival in cancer. Br J Cancer. 2012. — Formula, physiological or validation reference.
Reviewed by: MedicalC Clinical Editorial Team
Last reviewed: July 2026