Abstract
Elevated inflammatory markers are associated with poor outcomes in various types of cancers; however, their clinical significance in multiple myeloma (MM) have seldom been explored. This study investigated the prognostic relevance of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) in MM. Totally 559 MM patients were included in this study. NLR, PLR and MLR were calculated from whole blood counts prior to therapy. Kaplan-Meier curves and multivariate Cox proportional models were used for the evaluation of the survival. It has shown that newly diagnosed MM patients were characterized by high NLR and MLR. Elevated NLR and MLR and decreased PLR were associated with unfavorable clinicobiological features. Applying cut-offs of 4 (NLR), 100 (PLR) and 0.3 (MLR), elevated NLR, MLR and decreased PLR showed a negative impact on outcome. Importantly, elevated NLR and decreased PLR were independent prognostic factors for progression-free survival. Thus, elevated NLR and MLR, and decreased PLR predict poor clinical outcome in MM patients and may serve as the cost-effective and readily available prognostic biomarkers.
Highlights
Multiple myeloma (MM) is a malignant tumor of plasma cells characterized by a strong dependence on bone marrow milieu [1]
This study investigated the prognostic relevance of neutrophilto-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-tolymphocyte ratio (MLR) in MM
Diagnosed MM patients were characterized by high NLR and MLR
Summary
Multiple myeloma (MM) is a malignant tumor of plasma cells characterized by a strong dependence on bone marrow milieu [1]. It is becoming clear that MM microenvironment is largely orchestrated by inflammatory cells including macrophages, dendritic cells, mast cells and myeloid-derived suppressor cells [2,3,4]. These cells are the major sources of cytokines in MM-infiltrated bone marrow [5], and they can mediate immune suppression in MM. MM is characterized by high levels of CRP, IL-6, IGF-1, TGF-β and IL-17 as the markers of systemic inflammatory response [6]. These data suggest that a tight link exists between inflammation and pathogenesis in MM
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