Araştırma Makalesi
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Does the neutrophil-to-lymphocyte ratio affect survival in multiple myeloma?

Yıl 2026, Cilt: 19 Sayı: 1, 185 - 192, 16.01.2026

Öz

Purpose: Neutrophil-to-Lymphocyte Ratio (NLR) is an inflammatory marker that has shown prognostic significance in malignancies. This study aimed to investigate the relationship between NLR and overall survival (OS) as well as other prognostic indicators in patients diagnosed with Multiple Myeloma (MM).
Materials and methods: A total of 196 patients diagnosed with MM were included in the study. Demographic characteristics, laboratory values, clinical status, and the presence of autologous stem cell transplantation (ASCT) were retrospectively reviewed. The impact on overall survival and prognosis was evaluated.
Results: In the patient group with an NLR>1.8, the mean age was higher and the median OS was shorter. There was a statistically significant relationship between NLR and the presence of renal dysfunction, as well as being over 65 years of age (p=0.012, p=0.035). The presence of renal dysfunction, Stage 3 disease, age >65 years, and the absence of ASCT were associated with decreased overall survival (p=0.001, p=0.001, p<0.001, p<0.001, respectively). There was no direct correlation between NLR and OS.
Conclusion: In the present study, no correlation was found between OS and NLR. This may be due to the presence of other factors affecting the NLR, such as oxidative stress, infection, and inflammation. The existence of common parameters influencing both NLR and OS suggests that NLR is a useful marker in the assessment of survival and prognosis.

Kaynakça

  • Tsang M, Le M, Ghazawi FM, et al. Multiple myeloma epidemiology and patient geographic distribution in Canada: A population study. Cancer. 2019;125(14):2435-2444. doi:10.1002/cncr.32128
  • Maura F, Bergsagel PL. Molecular Pathogenesis of Multiple Myeloma: Clinical Implications. Hematol Oncol Clin North Am. 2024;38(2):267-279. doi:10.1016/j.hoc.2023.12.010
  • Seifert M, Scholtysik R, Küppers R. Origin and pathogenesis of B cell lymphomas. Methods Mol Biol. 2013;971:1-25. doi:10.1007/978-1-62703-269-8_1
  • Brigle K, Rogers B. Pathobiology and Diagnosis of Multiple Myeloma. Semin Oncol Nurs. 2017;33(3):225-236. doi:10.1016/j.soncn.2017.05.012
  • Kelkitli E, Atay H, Cilingir F, et al. Predicting survival for multiple myeloma patients using baseline neutrophil/lymphocyte ratio. Ann Hematol. 2014;93(5):841-846. doi:10.1007/s00277-013-1978-8
  • Shi L, Qin X, Wang H, et al. Elevated neutrophil-to-lymphocyte ratio and monocyte-to-lymphocyte ratio and decreased platelet-to-lymphocyte ratio are associated with poor prognosis in multiple myeloma. Oncotarget. 2017;8(12):18792-18801. doi:10.18632/oncotarget.13320
  • Wang H, Meng H, Wang J, et al. Clinical characteristics and prognostic values of 1p32.3 deletion detected through fluorescence in situ hybridization in patients with newly diagnosed multiple myeloma: a single-center study in China. Front Med. 2020;14(3):327-334. doi:10.1007/s11684-019-0712-x
  • Onec B, Okutan H, Albayrak M, et al. The predictive role of the neutrophil/lymphocyte ratio in survival with multiple myeloma: a single center experience. J Clin Lab Anal. 2017;31(2):e22032. doi:10.1002/jcla.22032
  • Wongrakpanich S, George G, Chaiwatcharayut W, et al. The Prognostic Significance of Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in Patients With Multiple Myeloma. J Clin Lab Anal. 2016;30(6):1208-1213. doi:10.1002/jcla.22004
  • Kyle RA, Gertz MA, Witzig TE, et al. Review of 1027 patients with newly diagnosed multiple myeloma. Mayo Clin Proc. 2003;78(1):21-33. doi:10.4065/78.1.21
  • Chow CC, Mo KL, Chan CK, Lo HK, Wong KS, Chan JC. Renal impairment in patients with multiple myeloma. Hong Kong Med J. 2003;9(2):78-82.
  • Child JA, Morgan GJ, Davies FE, et al. High-dose chemotherapy with hematopoietic stem-cell rescue for multiple myeloma. N Engl J Med. 2003;348(19):1875-1883. doi:10.1056/NEJMoa022340
  • Palumbo A, Avet-Loiseau H, Oliva S, et al. Revised International Staging System for Multiple Myeloma: A Report From International Myeloma Working Group. J Clin Oncol. 2015;33(26):2863-2869. doi:10.1200/JCO.2015.61.2267
  • Acquah ME, Hsing AW, McGuire V, Wang S, Birmann B, Dei-Adomakoh Y. Presentation and survival of multiple myeloma patients in Ghana: a review of 169 cases. Ghana Med J. 2019;53(1):52-58. doi:10.4314/gmj.v53i1.8

Multipl myelomda nötrofil lenfosit oranı sağkalımı etkiler mi?

Yıl 2026, Cilt: 19 Sayı: 1, 185 - 192, 16.01.2026

Öz

Amaç: Nötrofil Lenfosit Oranı (NLR), malignitelerde prognostik önemi gösterilen bir inflamasyon belirtecidir. Bu çalışmada MM tanılı hastalarda NLR oranının sağkalım ve diğer prognostik belirteçlerle ilişkisini incelemeyi amaçladık.
Gereç ve yöntem: Çalışmaya MM tanılı 196 hasta dahil edildi. Hastaların demografik özellikleri, laboratuvar değerleri, klinik durumları ve OKİT varlığı verileri geriye dönük olarak tarandı. Sağkalım ve prognoz üzerine etkileri değerlendirildi.
Bulgular: NLR>1.8 olan hasta grubunda yaş ortalaması daha yüksek, medyan OS daha kısa olarak bulundu. NLR ve renal disfonksiyon varlığı, >65 yaş arasında istatistiksel açıdan anlamlı bir ilişki vardı. (p=0,012, p=0,035) Renal disfonksiyon varlığı, Evre 3 hastalık, >65 yaş olma ve OKİT yapılmamış olma azalmış sağkalım ile ilişkiliydi. (p=0,001, p=0,001, p<0,001, p<0,001) NLR ve OS arasında direk olarak anlamlı bir ilişki saptanmadı.
Sonuç: Çalışmamızda OS ve NLR arasında ilişki saptanmaması NLR değerini etkileyen oksidatif stres, enfeksiyon, inflamasyon vb. gibi diğer durumların varlığına bağlı olabilir. NLR ve OS’yi etkileyen ortak parametrelerin olması NLR değerinin sağkalım ve prognozu değerlendirmede yardımcı bir belirteç olduğunu göstermektedir.

Kaynakça

  • Tsang M, Le M, Ghazawi FM, et al. Multiple myeloma epidemiology and patient geographic distribution in Canada: A population study. Cancer. 2019;125(14):2435-2444. doi:10.1002/cncr.32128
  • Maura F, Bergsagel PL. Molecular Pathogenesis of Multiple Myeloma: Clinical Implications. Hematol Oncol Clin North Am. 2024;38(2):267-279. doi:10.1016/j.hoc.2023.12.010
  • Seifert M, Scholtysik R, Küppers R. Origin and pathogenesis of B cell lymphomas. Methods Mol Biol. 2013;971:1-25. doi:10.1007/978-1-62703-269-8_1
  • Brigle K, Rogers B. Pathobiology and Diagnosis of Multiple Myeloma. Semin Oncol Nurs. 2017;33(3):225-236. doi:10.1016/j.soncn.2017.05.012
  • Kelkitli E, Atay H, Cilingir F, et al. Predicting survival for multiple myeloma patients using baseline neutrophil/lymphocyte ratio. Ann Hematol. 2014;93(5):841-846. doi:10.1007/s00277-013-1978-8
  • Shi L, Qin X, Wang H, et al. Elevated neutrophil-to-lymphocyte ratio and monocyte-to-lymphocyte ratio and decreased platelet-to-lymphocyte ratio are associated with poor prognosis in multiple myeloma. Oncotarget. 2017;8(12):18792-18801. doi:10.18632/oncotarget.13320
  • Wang H, Meng H, Wang J, et al. Clinical characteristics and prognostic values of 1p32.3 deletion detected through fluorescence in situ hybridization in patients with newly diagnosed multiple myeloma: a single-center study in China. Front Med. 2020;14(3):327-334. doi:10.1007/s11684-019-0712-x
  • Onec B, Okutan H, Albayrak M, et al. The predictive role of the neutrophil/lymphocyte ratio in survival with multiple myeloma: a single center experience. J Clin Lab Anal. 2017;31(2):e22032. doi:10.1002/jcla.22032
  • Wongrakpanich S, George G, Chaiwatcharayut W, et al. The Prognostic Significance of Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in Patients With Multiple Myeloma. J Clin Lab Anal. 2016;30(6):1208-1213. doi:10.1002/jcla.22004
  • Kyle RA, Gertz MA, Witzig TE, et al. Review of 1027 patients with newly diagnosed multiple myeloma. Mayo Clin Proc. 2003;78(1):21-33. doi:10.4065/78.1.21
  • Chow CC, Mo KL, Chan CK, Lo HK, Wong KS, Chan JC. Renal impairment in patients with multiple myeloma. Hong Kong Med J. 2003;9(2):78-82.
  • Child JA, Morgan GJ, Davies FE, et al. High-dose chemotherapy with hematopoietic stem-cell rescue for multiple myeloma. N Engl J Med. 2003;348(19):1875-1883. doi:10.1056/NEJMoa022340
  • Palumbo A, Avet-Loiseau H, Oliva S, et al. Revised International Staging System for Multiple Myeloma: A Report From International Myeloma Working Group. J Clin Oncol. 2015;33(26):2863-2869. doi:10.1200/JCO.2015.61.2267
  • Acquah ME, Hsing AW, McGuire V, Wang S, Birmann B, Dei-Adomakoh Y. Presentation and survival of multiple myeloma patients in Ghana: a review of 169 cases. Ghana Med J. 2019;53(1):52-58. doi:10.4314/gmj.v53i1.8
Toplam 14 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Hematoloji
Bölüm Araştırma Makalesi
Yazarlar

Seher Yılmaz 0009-0007-3277-5694

Gulsum Akgun Cagliyan 0000-0002-2073-1949

Eda Nilüfer Coşkun 0009-0000-2891-6801

İsmail Can Kendir 0000-0003-4372-7149

Kayıhan Kara 0009-0004-2454-5870

Sibel Hacıoğlu 0000-0003-0757-9206

Gönderilme Tarihi 11 Mayıs 2025
Kabul Tarihi 11 Ağustos 2025
Yayımlanma Tarihi 16 Ocak 2026
Yayımlandığı Sayı Yıl 2026 Cilt: 19 Sayı: 1

Kaynak Göster

AMA Yılmaz S, Akgun Cagliyan G, Coşkun EN, Kendir İC, Kara K, Hacıoğlu S. Does the neutrophil-to-lymphocyte ratio affect survival in multiple myeloma? Pam Tıp Derg. Ocak 2026;19(1):185-192. doi:10.31362/patd.1696956
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