The Prognostic Significance of Neutrophil to Lymphocyte Ratio in Patients with Multiple Myeloma

Abstract

Objective: The neutrophil-to-lymphocyte ratio(NLR) is a biomarker for systematic inflammation. It is also thought that the NLR can be used as a new biomarker by clinicians in predicting the prognosis of patients with multiple myeloma(MM). This study, aimed to retrospectively investigate the prognostic significance of pretreatment NLR in patients with MM, based on the hypothesis that elevated pretreatment NLR is a biomarker indicating worse survival in patients with MM. Materials and Methods: Patients aged >18 years with MM diagnosed, follow-up, and treated between January 2011 and December 2017 in the department of internal and geriatric medicine at Istanbul Faculty of Medicine were enrolled into this study. We retrospectively collected the data of 40 patients from the medical records. The relationship between NLR and baseline characteristics, laboratory parameters, prognosis, and survival outcome was analyzed. Results: The study showed that the mean NLR was 2.84±2.62 (0.1-14.8) in the whole blood count. No significant correlation was found between NLR and mortality (p=0.965). A significant relationship was found between higher stage and mortality (p=0.035). In addition, anemia, low albumin level, and elevated lactate dehydrogenas (LDH) level indicated poor survival time in patients with MM (p=0.022; p=0.031; p=0.023). Conclusion: Our study showed no relationship between NLR and both mortality and overall survival (OS). The above result can be explained by the fact that our study had some limitations such as the use of retrospective data from a single-center and the small sample size.

Keywords

• overall survival
• Multiple myeloma
• neutrophil-lymphocyte ratio

Multiple Miyelom Hastalarında Nötrofil Lenfosit Oranının Prognostik Önemi

Abstract

Amaç: Nötrofil-lenfosit oranı (NLR), bir sistematik inflamasyon biyobelirtecidir. Multipl miyelomlu (MM) hastalar için de NLR'nin prognozu öngörmede yeni bir biyobelirteç olarak klinisyene yardımcı olabileceği düşünülmektedir. Bu çalışmada, tedavi öncesi NLR'nin MM hastalarında daha kötü bir sağkalım biyobelirteci olduğu hipotezine dayanarak, MM'lu hastalarda tedavi öncesi NLR'nin prognostik önemini retrospektif olarak araştırmayı amaçladık. Gereç ve Yöntem: Çalışmaya, İstanbul Tıp Fakültesi İç Hastalıkları ve Geriatri Anabilim Dalı'nda Ocak 2011 - Aralık 2017 tarihleri arasında tanı, takip ve tedavi gören 18 yaş üstü MM hastaları alındı. 40 hastanın verileri tıbbi kayıtlardan retrospektif olarak toplandı. NLR ile temel özellikler, laboratuvar parametreleri, prognoz ve sağkalım arasındaki ilişki analiz edildi. Bulgular: Mevcut çalışma, tam kan sayımında ortalama NLR'nin 2,84±2,62 (0,1-14,8) olduğunu gösterdi. NLR ile mortalite arasında anlamlı bir ilişki bulunmadı (p=0,965). Yüksek evre ile ölüm arasında anlamlı bir ilişki vardır (p=0,035). Ayrıca anemi, düşük albümin düzeyi ve yüksek laktat dehidrogenaz (LDH) düzeyi MM'lu hastalarda kötü sağkalım süresine işaret ediyordu (p=0,022; p=0,031; p=0,023). Sonuç: Çalışmamız NLR ile mortalite ve genel sağkalım (OS) arasında bir ilişki olmadığını gösterdi. Çalışmamızda NLR ile mortalite ve OS arasında bir ilişkinin olmamasının nedeni, çalışmamızın tek merkezden geriye dönük verilerin toplanması ve küçük örneklem büyüklüğü gibi bazı sınırlılıklara sahip olması olabilir.

Keywords

• Multiple myelom
• nötrofil lenfosit oranı
• genel sağkalım

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