Annals of Hematology

, Volume 95, Issue 1, pp 55–61 | Cite as

Prognostic value of the inverse platelet to lymphocyte ratio (iPLR) in patients with multiple myeloma who were treated up front with a novel agent-containing regimen

  • Sung-Hoon Jung
  • Jin Seok Kim
  • Won Sik Lee
  • Suk Joong Oh
  • Jae-Sook Ahn
  • Deok-Hwan Yang
  • Yeo-Kyeoung Kim
  • Hyeoung-Joon Kim
  • Je-Jung LeeEmail author
Original Article


Recently, reactive thrombosis or platelet to lymphocyte ratio has been reported as a strong predictor of poor prognosis in various types of cancer. However, a study investigating the relationship between platelet counts and thrombopoietic cytokines suggested that low platelet could be important in multiple myeloma (MM), which means platelet count decreased in advanced International Staging System (ISS) stage. Therefore, we developed inverse platelet to lymphocyte ratio (iPLR) and assessed the prognostic value of iPLR in patients with MM. We retrospectively analyzed 283 patients who were treated up front with a novel agent-containing regimen. Patients were classified into three groups based on hazard ratio (HR) according to iPLR: low iPLR (group 1), middle iPLR (group 2), and high iPLR (group 3). Over a median follow-up of 34.8 months, staging by iPLR group had predictive value for progression-free survival (PFS) and overall survival (OS). In addition, staging by iPLR group was a reliable method to predict for survival in patients who presented with renal failure (eGFR < 60 mL/min/1.73 m2) and in elderly patients. Multivariate analyses demonstrated that staging by iPLR group was associated with PFS and OS in patients with MM. In conclusion, this study suggested that iPLR is a simple and reliable inflammatory prognostic factor in the era of novel agents.


Inflammation Platelet Lymphocyte Multiple myeloma 


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Sung-Hoon Jung
    • 1
  • Jin Seok Kim
    • 2
  • Won Sik Lee
    • 3
  • Suk Joong Oh
    • 4
  • Jae-Sook Ahn
    • 1
  • Deok-Hwan Yang
    • 1
  • Yeo-Kyeoung Kim
    • 1
  • Hyeoung-Joon Kim
    • 1
  • Je-Jung Lee
    • 1
    Email author
  1. 1.Department of Hematology-OncologyChonnam National University Hwasun HospitalHwasunRepublic of Korea
  2. 2.Division of Hematology, Department of Internal MedicineYonsei University College of MedicineSeoulRepublic of Korea
  3. 3.Hemato-oncology, Busan Paik HospitalInje UniversityBusanRepublic of Korea
  4. 4.Department of Internal Medicine, Kangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulRepublic of Korea

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