Correlation Between Peripheral Blood Neutrophil/Lymphocyte Ratio And Cytogenetics In Newly Diagnosed Multiple Myeloma Patients And Its Value For Prognostic Stratification

PurposeTo explore the correlation between Neutrophil to Lymphocyte Ratio(NLR)and cytogenetics in newly diagnosed multiple myeloma(MM)patients,and to explore the value of NLR in prognostic stratification of newly diagnosed MM patients.MethodsA total of 200 MM patients treated in Ganzhou People’s Hospital from December 2011 to December 2021 were selected as the research object and set as the research group.The basic data of MM patients were collected,such as creatinine,hemoglobin,central granulocyte count,lymphocyte count,D-S stage,ISS stage,etc.At the same time,110 healthy people who underwent physical examination in the Department of Physical Examination of Ganzhou People’s Hospital were selected as the research objects and set as the reference group.The peripheral blood test results of MM patients before the first chemotherapy were used as the basis to calculate the corresponding NLR values,and the peripheral blood NLR values of the two groups of patients were statistically analyzed.ROC curve was used to determine the sensitivity and specificity.Then 200 MM patients were divided into two subgroups according to whether the NLR value was >4,namely,141 patients in the low NLR group(NLR≤4group)and 59 patients in the high NLR group(NLR>4 group).The correlation between NLR and cytogenetics was further analyzed.Subsequently,univariate and multivariate analyses were carried out to clarify its impact on the prognosis of newly diagnosed MM patients,and further stratified the prognosis of newly diagnosed MM patients to screen out the independent factors and indicators affecting the prognosis of newly diagnosed MM patients.Results1.There is a significant statistical difference in NLR level between newly diagnosed MM patients and healthy people.The NLR level of newly diagnosed MM patients is significantly higher than that of healthy people(P<0.05).2.The newly diagnosed MM patients in the high NLR group had obvious anemia,thrombocytopenia,extramedullary infiltration and other problems compared with those in the low NLR group(P<0.05).The positive rates of TP53 and RB-1expression in FISH of newly diagnosed MM patients in the high NLR group were significantly higher than those in the low NLR group(P<0.05).3.According to the results of univariate analysis: TP53 positive,RB-1,1q21 amplification,extramedullary infiltration,HB≤85g/L,NLR>4 were significantly associated with progression-free survival(PFS)of newly diagnosed MM patients.P<0.05.TP53 positive,1q21 amplification,extramedullary infiltration,HB≤85g/L,NLR>4,LDH>200U/L were significantly correlated with the overall survival(OS)of newly diagnosed MM patients(P<0.05).4.The results of multivariate analysis showed that NLR>4,TP53 positive and HB < 85g/L were independent risk factors for poor prognosis of newly diagnosed MM patients(P<0.05).5.According to the survival curve,the median PFS and OS time of newly diagnosed MM patients with NLR>4 was lower than that of newly diagnosed MM patients with NLR≤4,P<0.05.6.In newly diagnosed MM patients with NLR>4,there were significant statistical differences in prognosis PFS and OS between TP53 positive and TP53 negative patients(P<0.05).Conclusion1.Compared with MM patients in the low NLR group,the positive levels of TP53 and RB-1 expression in cytogenetic FISH of MM patients in the high NLR group were more significantly increased,which indicated that the NLR level in MM patients was positively correlated with the incidence of cytogenetic positivity.2.Compared with MM patients in the high NLR group,MM patients in the low NLR group had more obvious prognostic effect and higher disease remission rate after treatment.3.High NLR indicates poor prognosis of newly diagnosed MM patients,which indicates that in addition to D-S stage and ISS stage,peripheral blood NLR level can also be used as an indicator to predict prognosis stratification of newly diagnosed MM patients.