What Is the Neutrophil-to-Lymphocyte Ratio (NLR)?

Q: What Is the Neutrophil-to-Lymphocyte Ratio (NLR)?

NLR = neutrophils ÷ lymphocytes. Normal 1-3. Elevated NLR indicates inflammation and is associated with worse outcomes in cardiovascular disease and cancer.

NLR is calculated by dividing the absolute neutrophil count by the absolute lymphocyte count.

Normal Range

1.0–3.0

Elevated NLR (above 3)

Acute bacterial infection
Chronic inflammation
Stress response
Cardiovascular disease (worse prognosis)
Cancer (worse prognosis)

Low NLR (below 1)

Viral infection
Autoimmune disease
Certain medications

Why It Matters

Simple calculation from standard CBC
Emerging prognostic marker
Reflects the balance between innate (neutrophil) and adaptive (lymphocyte) immunity

Source: NLM MedlinePlus, American Association for Clinical Chemistry.

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