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| Prognostic value of neutrophil / lymphocyte ratio and platelet/lymphocyte ratio for progression-free survival in patients with multiple myeloma initially treated with a three-drug combination regimen |
| CHAO Ling1 XIE Jing2 XU Ye1 QIU Xiaolian3 |
1. Department of Laboratory Medicine, Yichun People′s Hospital, Jiangxi Province, Yichun 336000, China;
2. Yichun Vocational and Technical College, Jiangxi Province, Yichun 336028, China;
3. Department of Hematology, Yichun People′s Hospital, Jiangxi Province, Yichun 336000, China |
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Abstract Objective To explore the relationship between the efficacy and prognosis of neutrophil/lymphocyte ratio (NLR) and platelet / lymphocyte ratio (PLR) in progression-free survival (PFS) in patients with newly treated multiple myeloma (MM) who received three-drug regimen (RCD regimen). Methods Seventy newly diagnosed MM patients in Yichun People′s Hospital from January 2016 to June 2018 were selected as the research subjects. All patients were treated with RCD regimen. According to the efficacy, patients were divided into ≥ very good partial response (VGPR) group and < VGPR group, and the differences of NLR and PLR between the two groups were compared. The predictive value of serum NLR and PLR for curative effect was analyzed by ROC curve, and AUC, sensitivity and specificity were calculated. The 3-year PFS survival curve of MM patients was constructed by Kaplan-Meier method, and the survival curve was analyzed by log-rank test. Multivariate Cox regression analysis was performed on the factors affecting prognosis in univariate analysis. Results NLR and PLR in ≥VGPR group were lower than those in < VGPR group, and the differences were statistically significant (P<0.05). ROC curve analysis showed that the AUC, sensitivity and specificity of NLR for predicting post-treatment efficacy were 0.802, 70.5% and 82.7% respectively. The AUC of PLR was 0.794, the sensitivity was 66.7%, and the specificity was 84.6%. The AUC of NLR+PLR was 0.843, the sensitivity was 61.5%, and the specificity was 94.2%. The AUC, sensitivity and specificity of NLR+PLR were the highest. Univariate analysis showed that β2 microglobulin, NLR and PLR were the related factors affecting PFS 3 years after treatment (P<0.05). Log-rank test showed that the 3-year PFS of patients with low NLR and PLR was better than that of patients with high NLR and PLR. Multivariate Cox regression analysis showed that NLR <2.55 and PLR <143.88 were protective factors for PFS in MM patients within 3 years after treatment (P<0.05). Conclusion The NLR and PLR of MM patients are related to the curative effect. Higher NLR and PLR predicted shorter progression-free survival time in patients with MM. The combined application of NLR and PLR can better evaluate the prognosis of newly diagnosed MM patients, and has important guiding significance for the clinical treatment and curative effect of the patients.
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