Value Of Neutrophil/Lymphocyte Ratio And Monocyte/Lymphocyte Ratio In The Prognosis Of Patients With Multiple Myeloma

Objective:The clinical data of 90 patients with multiple multiple myeloma（MM）in Gansu Hospital were collected and analyzed to explore the prognostic value of neutrophil-to-lymphocyte ratio（NLR）and monocyte-to-lymphocyte ratio in patients with MM.To provide an accurate,convenient and economical prognosis for the prognosis assessment of MM patients,so as to provide clinical basis for reasonable diagnosis and treatment of MM patients.Methods:The clinical data of 90 MM patients who met the inclusion and exclusion criteria at the hematology department of gansu provincial people’s hospital from March 2009 to March 2019 were retrospectively analyzed.According to the ROC curve respectively determine the optimal threshold of the NLR and MLR,divided the patients into high ratio groups（high NLR group and high MLR）group and the low ratio（low NLR group and low MLR）,analysis on age,gender,β_2-microglobulin（β₂-MG）,serum calcium,serum creatinine（Cr）,hemoglobin（Hb）,the proportion of plasma cells,ISS stage,Albumin（Alb）,and Lactate dehydrogenase（LDH）in the difference;Grouping of age,gender,and the laboratory indicators ofβ₂-MG and above was carried out to compare the difference of survival rate among each group.The prognostic value of high NLR/MLR group and low NLR/MLR group in the traditional chemotherapy group,the new drug therapy group,and the different groups of age,plasma cell ratio,LDH,and ISS stage were analyzed.Univariate and multivariate regression analysis was used to analyze the relationship between the above clinical indicators and the prognosis of MM patients.Results:1.ROC curve analysis determined the toptimal threshold of NLR to be3.5（sensitivity 69.2%,specificity 73.4%）,the area under the curve to be 0.733,95%CI（0.615-0.852）,MLR to be 0.34,（sensitivity 84.6%,specificity 54.7%）,the area under the curve to be 0.632,95%CI（0.509-0.755）.There were no statistically significant differences in age,gender,β₂-MG,serum calcium,Cr,Hb,plasma cell ratio,ISS stage,Alb,LDH between the low NLR/MLR group（NLR<3.5/MLR<0.34）and the high NLR/MLR group（（NLR≥3.5/MLR≥0.34））,which were comparable（P>0.05）.2.In different groups of NLR,MLR,Cr,LDH,ISS stage andβ₂-MG,there were differences in OS between each group,and the prognosis of the high ratio group was lower than that of the lower ratio group（P<0.05）.However,there was no significant difference in the survival rate among groups including age,sex,serum calcium,Hb,plasma cell ratio and Alb.3.In the new drug treatment group,the traditional chemotherapy group,and the different stratification groups of ages,β₂-MG,ISS stage,plasma cell ratio and LDH,there were differences in OS in the high MLR/NLR group and the low MLR/NLR group（P<0.05）.4.The results of single factor analysis showed that NLR,MLR,β₂-MG,Cr,LDH and ISS stages were the risk factors influencing the prognosis of MM patients（P<0.05）.The results of multivariate analysis showed that NLR alone was an independent risk factor affecting the prognosis of MM patients（P<0.05）.Conclusion:1.For newly diagnosed MM patients,elevated NLR and MLR indicate poor prognosis,and NLR and MLR may be an indicator for the assessment of the condition and prognosis of MM patients.2.β₂-MG,Cr,LDH and ISS stage are risk factors affecting the prognosis of patients with MM,not independent risk factors,but the increase of these indicators was associated with low OS.3.In the new drug treatment group and the traditional chemotherapy group,there was a significant difference in OS between the low NLR/MLR group and the high NLR/MLR group;Compared with the traditional chemotherapy group,the new drug treatment group can prolong the OS of MM patients in the high MLR group,which may provide some reference value for the optimization and selection of treatment scheme for MM patients.