Prognostic Value Of Peripheral Blood Lymphocyte And Monocyte Counts?Their Ratios?Red Cell Volume Distribution Width In Multiple Myeloma

Objective:Peripheral blood lymphocyte count(ALC),monocyte count(AMC),lymphocyte count/monocyte count(LMR),and red blood cell distribution width(RDW)have been reported as different types of inflammatory biomarkers and prognostic factors.This study focused on the prognostic value of ALC,AMC,LMR and RDW in multiple myeloma.Methods:The study retrospectively analyzed 109 patients with newly diagnosed MM from January 2011 to December 2018,and the correlation between peripheral blood ALC,AMC,LMR,RDW levels and other clinical datas were analyzed.The cutoff value of ALC,AMC,LMR,and RDW were determined by receiver operating characteristic(ROC)curves.Survival analysis was analyzed by Kaplan-Meier method,log-rank test and COX proportional risk model were used for univariate and multivariate analysis of prognosis.Results:ALC<1.17�10~9/L,AMC?0.39�10~9/L,LMR<2.43 and RDW?15.05%were associated with poor PFS and OS of MM(P<0.05).There was a correlation between ALC and ISS stage,lactate dehydrogenase(LDH),albumin(ALB),?2-MG and plasma cell ratio(all P<0.05).AMC was associated with hemoglobin,?2-microglobulin(?2-MG),lactate dehydrogenase,serum creatinine levels,and plasma cell ratio(P<0.05).LMR was correlated with?2-MG,LDH and ALB level(P<0.05).RDW was associated with hemoglobin(Hb),LDH,ALB,serum creatinine levels,and plasma cell ratio(P<0.05).The response rates of patients with low RDW and high LMR were higher than those of high RDW and low LMR(P<0.05).Univariate analysis showed that age<65 years old,ALC<1.17�10~9/L,Hb<110g/L,?2-MG<5.5mg/L,ALB<35g/L,LDH<247U/L,AMC<0.39�10~9/L,LMR>2.43 and RDW<15.05%were the related factors for better prognosis of newly diagnosed MM(P<0.05).Multivariate analysis showed that LDH,ALC,LMR ratio and plasma cell ratio were independent prognostic factors for newly diagnosed MM.Conclusions:The decrease of ALC,LMR and the increase of AMC and RDW in peripheral blood are negatively correlated with PFS and OS in newly diagnosed MM patients.Therefore,ALC,AMC,LMR and RDW can be used as predictors of poor prognosis of MM.In addition,patients with high LMR and low RDW have better therapeutic effects and can predict treatment response.