Predictive Value Of The Fibrinogen And Lactate Dehydrogenase To Albumin Ratio On The Efficacy Of Newly Diagnosed Patients With Multiple Myeloma

Objective:To explore the predictive value of the fibrinogen to albumin ratio(FAR)and lactate dehydrogenase to albumin ratio(LAR)on the efficacy of patients with newly diagnosed multiple myeloma(MM),so as to provide reference for clinical treatment.Methods:A total of 108 patients with newly diagnosed MM were included.Collecting the main clinical data,laboratory indicators before their first treatment,the treatment regimens and the efficacy of completing the four courses of chemotherapy.ROC curve was drawn to calculate the maximum area under curve(AUC)and optimum cut-off values of FAR and LAR.The clinical features of high FAR group and low FAR group,high LAR group and low LAR group were compared withχ~2test.Patients were divided into remission group(CR,VGPR and PR)and non-remission group(SD and PD)according to the efficacy of 4 courses of chemotherapy.T test and rank sum test were used to compare the FAR and LAR levels of the two groups.Cox proportional hazard regression model was used for univariate and multivariate analyses.Results:1.Among 108 newly diagnosed MM patients,82 cases in remission group(CR 21cases,VGPR 18 cases,PR 43 cases),and 26 cases in non-remission group(SD 11 cases,PD 15 cases).According to ROC curve,the maximum AUCs of FAR and LAR were0.729(95%CI 0.626～0.832)and 0.720(95%CI 0.601～0.838),which were bigger than the fibrinogen(FIB),albumin(ALB)and lactate dehydrogenase(LDH).It is suggested that FAR and LAR can predict the efficacy of MM patients more objectively.The optimum cut-off values of FAR and LAR were 0.075 and 6.720,respectively.2.There was a statistically significant difference in ALB between high FAR group and low FAR group(P=0.001).There were significant differences in hemoglobin(HB)(P=0.006)and LDH(P<0.001)between high LAR group and low LAR group.3.After completing the four courses of chemotherapy,the levels of FAR and LAR in the remission group were significantly lower than those in the non-remission group,and the difference between the two groups was statistically significant(P<0.05).4.Univariate analysis showed that there were significant differences in LDH,ISS stage,bone marrow plasma cells percentage(BMPC),FAR and LAR between the two groups(P<0.05).Multivariate analysis showed that high FAR was an independent risk factor affecting the efficacy of newly diagnosed MM(HR=8.020,95%CI 1.072～60.032,P=0.043).Conclusions:1.The FAR level in newly diagnosed MM patients was correlated with serum ALB level.The high level of FAR indicates poor remission,which can be used as a predictor for efficacy.More actively individualized therapy is needed for MM patients with high FAR.2.The LAR level in newly diagnosed MM patients was correlated with HB and serum LDH level.There was no obvious correlation between the LAR level and the efficacy of newly diagnosed MM patients in this group.3.Although LDH,ISS stage,BMPC and LAR were statistically different in newly diagnosed MM patients with different efficacy,they could not be regarded as independent influencing factors for efficacy of newly diagnosed MM patients.