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Clinical significance of the lymphocyte-to-monocyte ratio in multiple myeloma patients with negative minimal residual disease: a single-center retrospective analysis

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Abstract

Minimal residual disease (MRD) is a surrogate marker for survival in multiple myeloma (MM), while the lymphocyte-to-monocyte ratio (LMR) is a prognostic factor associated with the patients’ immunological status. We retrospectively evaluated the clinical impact of MRD negativity and LMR. MRD was analyzed by multicolor flowcytometry (threshold, 1 × 10–5). Fifty-eight patients (median age 70 years) who achieved complete response were included in this study. Twenty-two patients received autologous stem cell transplantation, 14 received daratumumab-based chemotherapy, and 22 received another treatment. Forty-one (70.7%) patients achieved MRD negativity. Over the median follow-up time of 15.1 months, PFS in MRD-negative patients was significantly longer than in MRD-positive patients (P = 0.020). In addition, a high LMR at MRD assessment was associated with MRD negativity (P = 0.019) and long PFS (P = 0.009). Finally, neither MRD negativity nor high LMR at MRD assessment was associated with significantly shorter PFS compared with MRD positivity or low LMR (P = 0.002). In conclusion, high LMR was associated with MRD negativity and can be used as a predictor of long PFS. Change of treatment strategy might be essential for patients with MRD positivity and high LMR at MRD assessment due to their short PFS.

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Acknowledgements

We would like to thank the attending doctors and nurses at the Jikei University Kashiwa Hospital. We would also like to extend gratitude to the myeloma patients and their families for consenting to participate in our study.

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Authors and Affiliations

  1. Division of Clinical Oncology/Hematology, Department of Internal Medicine, The Jikei University Kashiwa Hospital, 163-1 Kashiwa-shita, Kashiwa, Chiba, 277-8567, Japan

    Kazuhito Suzuki, Kaichi Nishiwaki, Riku Nagao, Mitsuji Katori, Ryoko Fukushima, Daiki Hattori & Hidekazu Masuoka

  2. The Jikei University School of Medicine, Tokyo, Japan

    Kazuhito Suzuki, Kaichi Nishiwaki, Riku Nagao, Mitsuji Katori, Ryoko Fukushima, Daiki Hattori, Hidekazu Masuoka & Shingo Yano

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  1. Kazuhito Suzuki
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  2. Kaichi Nishiwaki
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Correspondence to Kazuhito Suzuki.

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Conflict of interest

K. Suzuki received personal fees from Takeda Pharmaceutical Company, Janssen Pharmaceutical K.K., Celgene, outside the submitted work; K. Nishiwaki reports personal fees from Kyowa Hakko Kirin Co, Ltd, outside the submitted work; Dr. Yano reports grants from Kyowa Kirin, grants from Astella Pharma, grants from Chugai Pharama, grants from Mochida Pharama, grants from Lilly Phrama, grants from Takeda Pharama, grants from MDS Pharama, grants from Pfizer, grants from Dai Nippon Sumitomo Pharama, grants from Ono Pharma, outside the submitted work; the other authors declare that they have no conflict of interest.

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Suzuki, K., Nishiwaki, K., Nagao, R. et al. Clinical significance of the lymphocyte-to-monocyte ratio in multiple myeloma patients with negative minimal residual disease: a single-center retrospective analysis. Int J Hematol 114, 599–607 (2021). https://doi.org/10.1007/s12185-021-03201-y

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  • DOI: https://doi.org/10.1007/s12185-021-03201-y

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