The Changes Of PLR In Patients With Multiple Myeloma And Its Relationship With Clinicopathological Features And Prognosis

Objective To observe the changes of platelet-to-lymphocyte ratio（PLR）in patients with multiple myeloma（MM）,and to explore the relationship between PLR and clinicopathological characteristics and prognosis.Methods The clinical data of 180 patients with multiple myeloma（MM group）treated in the Affiliated Hospital of Qingdao University from January 2009 to January 2017 were collected,and 90 healthy persons（control group）were selected during the same period.The number of platelets and lymphocyte in MM group and control group was counted by XN9000 blood analyzer and its matching reagent.Then PLR was calculated and the difference of PLR between MM group and control group was compared.Receiver Operating Characteristic（ROC）curve was used to determine the optimum cut-off point of PLR in 180 patients with multiple myeloma.According to the optimum cut-off point,180patients with multiple myeloma were divided into low PLR group and high PLR group.The differences in age,sex,creatinine,albumin,hemoglobin,beta2-microglobulin（β₂-MG）,lactate dehydrogenase（LDH）,international staging system（ISS）,immunophenotyping and other clinicopathological parameters,Progression-free Survival（PFS）time and Overall Survival（OS）time between the two groups were compared.Results The PLR of MM group was lower than that of healthy control group,and there was significant difference between the two groups（P<0.05）.The optimum cut-off point of PLR for 180 patients with multiple myeloma was 117.92 by ROC curve.With the optimum cut-off point,180 patients with multiple myeloma were divided into high PLR group and low PLR group,108 patients in low PLR group（PLR<117.92）and 72patients in high PLR group（PLR≥117.92）.Univariate analysis showed that PLR<117.92,LDH andβ₂-MG were risk factors affecting the prognosis of patients with multiple myeloma（all P<0.05）.Multivariate analysis showed that LDH and ISS stages were risk factors affecting the prognosis of patients with multiple myeloma（all P<0.05）.Compared with the high PLR group,the level of serum albumin in the low PLR group was lower,and there was significant difference between the two groups（P<0.05）;there was no significant difference between the two groups in age,creatinine,LDH,albumin,hemoglobin,β₂-MG,immunophenotyping,ISS stage and other clinicopathological parameters（all P>0.05）.In terms of progression-free survival time,the median progression-free survival time was 11 months in the low PLR group and 21 months in the high PLR group.There was no significant difference between the two groups（P>0.05）.In terms of overall survival time,the median overall survival time of the low PLR group was 16 months,and that of the high PLR group was 24 months.The median overall survival time of the low PLR group was shorter than that of the high PLR group,and the difference between the two groups was statistically significant（P<0.05）.Conclusion The study demonstrated that multiple myeloma patients are often accompanied by a decrease in PLR.The median overall survival time of patients with low PLR is generally shorter than that of patients with high PLR.Therefore,PLR can be used as an indicator of inflammation and immune status,is of great significance in evaluating the prognosis of patients with multiple myeloma.