Peripheral blood absolute lymphocyte count, absolute monocyte count and their ratio in prognosis prediction of newly diagnosed multiple myeloma / 肿瘤

ABSTRACT

Objective: To investigate the value of peripheral blood absolute lymphocyte count (ALC), absolute monocyte count (AMC) and ALC/AMC ratio (LMR) in predicting the prognosis of patients with newly diagnosed multiple myeloma (MM). Methods: Retrospective analysis was performed in 190 patients with newly diagnosed MM from Tianjin Medical University Cancer Institute and Hospital between January 2005 and December 201 5. The relationships of peripheral blood ALC, AMC and LMR with peripheral blood hemoglobin (Hb), β2-microglobulin (β2-MG) and lactate dehydrogenase (LDH) and the proportion of bone marrow plasma cells were analyzed. The cutoff values of ALC, AMC and LMR were determined by the receiver operating characteristic (ROC) curve in patients with newly diagnosed MM. Survival analysis was performed using Kaplan-Meier method and the log-rank test for univariate analysis of prognosis, and a COX proportional hazard model was used for multivariate analysis of prognosis. Results: The cutoff values of ALC, AMC and LMR determined by ROC curve were 1.24×109/L, 0.60×109/L and 3.90, respectively. According to these cutoff values, the patients were divided into high value groups and low value groups. The results of multivariate analysis showed that ALC 247 U/L (HR: 1.972, 95% CI: 1.087-3.576; P = 0.025) were independent poor prognostic factors in untreated MM patients. According to the number of poor prognostic factors (each poor prognostic factor was scored as one), the patients were divided into score 0, 1-2 and 3 groups, the overall survival and progression-free survival of the three groups were significantly different (all P < 0.05). Conclusion: Lower ALC and LMR values may indicate poor prognosis. ALC < 1.24×109/L and LMC≤3.90 maybe the independent poor prognostic factors in patients with newly diagnosed MM.