The Predictive Value Of Inflammation-related Indices Of Peripheral Blood Cells In Patients With Multiple Myeloma

Background:Inflammation is closely related to the occurrence,progression and prognosis of cancer.Therefore,it is very important to evaluate the inflammatory status in cancer patients.In addition to the commonly used inflammatory biomarkers,such as C-reactive protein,interleukin-6,some studies have found that some inflammation-related biomarkers derived from peripheral blood cells correlate with the survival of cancer patients,suggesting that these biomarkers may be used as candidate predictors of prognosis in cancer patients.Multiple myeloma(MM)is a common hematopoietic malignancy,and its prognosis is affected by variable factors.However,the predictive value of peripheral blood cells indices for the prognosis of MM remains undetermined.Objective:To study the predictive value of peripheral blood cells indices,as well as other biomarkers,in MM disease progression and death.Methods:We retrospectively analyzed 138 newly diagnosed MM patients treated in the Affiliated Hospital of North Sichuan Medical College from January 2010 to December 2016.Clinical and laboratory information were collected at the time of diagnosis.Patients were followed up for treatment,disease progression and survival,and the deadline of our follow-up was December 31,2017.SPSS software(v.23.0)was used for statistical analysis.Descriptive analysis was adopted for general information.The receiver operating characteristic curve(ROC)was applied to analyze continuous variables that may have effects on patients’survival,and the optimal cut-off values were calculated by ROC analysis.The life-table method was used for calculating the median survival time and plotting the cumulative survival rate curve.The Cox regression model was used for univariate and multivariate analysis.Result:1.138 patients were finally involved in this study,among which82 were male and 56 females,with a median age of 62.5 years(41-88 years);the median time of progression-free survival(PFS)was 31.8 months(1-63months),and median time of overall survival(OS)was 41.5 months(7-64months);2.ROC analysis suggested that age,absolute neutrophil count(ANC),platelet count(PC),mean platelet volume(MPV),neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR)and C-reactive protein(CRP)may have predictive value for the survival of MM patients;3.Univariate analysis showed that baseline MPV,CRP,serum creatinine(SCr)were related to PFS(P<0.05).MPV≤10.25fl,CRP>4.51mg/L,SCr>176.8μmol/L were risk factors affecting PFS.The presenting age,ANC,PLT,MPV,NLR,platelet/monocyte ratio(PMR),PLR,CRP,SCr,ISS stage,treatment regimens were related to OS(P<0.05),specifically,age>62.5years,ANC>2.895×10~9/L,PLT>114.5×10~9/L,MPV≤10.25fl,NLR>2.728,PMR>215.576,PLR>80.945,CRP>4.51mg/L,SCr>176.8μmol/L,ISS stage III,and receiving traditional chemotherapy regimens were risk factors for patients’death.4.Multivariate analysis showed that Hb≤63.50g/L,MPV≤10.25fl and SCr>176.8μmol/L were independent risk factors for disease progression in MM;PLT>114.5×10~9/L,MPV≤10.25fl,NLR>2.728,CRP>4.51mg/L,ISS stage III,and receiving traditional chemotherapy regimen were independent risk factors for death.Conclusion:1.Severe anemia and lower MPV are independent risk factors affecting disease progression in MM;higher PLT,NLR and lower MPV are independent risk factors for death in MM;2.In our study,platelet-related indices display good prognostic correlation in MM patients,among which,higher PC and lower MPV are both independent risk factors affecting disease progression;3.Due to its retrospective trait,prospective cohorts involving more patients are needed to confirm the present results.