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Predicting survival for multiple myeloma patients using baseline neutrophil/lymphocyte ratio

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Abstract

The neutrophil/lymphocyte ratio (NLR) at diagnosis has been shown to be a prognostic factor for survival in solid tumors. The NLR at diagnosis as a prognostic factor for multiple myeloma (MM) has not been studied. Therefore, the focus of the study was the correlation of NLR with the proven prognostic parameters in patients with MM. A total of 151 MM patients who fulfilled the International Myeloma Working Group (IMWG) criteria were enrolled in the study by a retrospective review of the patients' records. One hundred fifty-one age- and gender-matched healthy controls were also included in the study. NLR was calculated using data obtained from the complete blood count (CBC). NLR was significantly higher in MM patients than the control group (2.79 ± 1.82 vs. 1.9 ± 0.61, respectively; p < 0.0001). The median follow-up on living patients in this study was 41 months. NLR at the diagnosis was found to be an independent predictor for overall survival (OS) and event-free survival (EFS) by univariate and multivariate analysis. Patients with a NLR <2 at diagnosis experienced superior OS compared with patients with a NLR ≥2 (5-year OS rates were 87.5 and 42.4 %, respectively; p < 0.0001). In a similar fashion, superior EFS was observed in patients with a NLR <2 at the diagnosis compared with patients with a NLR ≥2 (5-year EFS rates were 88.4 and 41.8 %, respectively, p < 0.0001). This study suggests that NLR at the diagnosis is a simple, inexpensive, possible prognostic factor to assess clinical outcomes in MM patients.

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References

  1. Greipp PR, San Miguel J, Durie BG, Crowley JJ, Barlogie B, Bladé J et al (2005) International staging system for multiple myeloma. J Clin Oncol 23:3412–3420

    Article  PubMed  Google Scholar 

  2. Wuilleme S, Robillard N, Lodé L, Magrangeas F, Beris H, Harousseau JL et al (2005) Ploidy, as detected by fluorescence in situ hybridization, defines different subgroups in multiple myeloma. Leukemia 19:275–278

    Article  PubMed  CAS  Google Scholar 

  3. Zahorec R (2001) Ratio of neutrophil to lymphocyte counts—rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy 102:5–14

    PubMed  CAS  Google Scholar 

  4. Mohri Y, Tanaka K, Ohi M, Yokoe T, Miki C, Kusunoki M (2010) Prognostic significance of host- and-tumor-related factors in patients with gastric cancer. World J Surg 34:285–290

    Article  PubMed  Google Scholar 

  5. Walsh SR, Cook EJ, Goulder F, Justin TA, Keeling NJ (2005) Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol 91:181–184

    Article  PubMed  CAS  Google Scholar 

  6. Halazun K, Hardy MA, Rana AA, Woodland DC, Luyten EJ, Mahadev S et al (2009) Negative impact of neutrophil/lymphocyte ratio on outcome after liver transplantation for hepatocellular carcinoma. Ann Surg 250:141–151

    Article  PubMed  Google Scholar 

  7. Porrata LF, Ristow K, Habermann T, Inwards DJ, Micallef IN, Markovic SN (2010) Predicting survival for diffuse large B-cell lymphoma patients using baseline neutrophil/lymphocyte ratio. Am J Hematol 85:896–899

    Article  PubMed  Google Scholar 

  8. Durie BG, Harousseau JL, Miguel JS, Bladé J, Barlogie B, Anderson K et al (2006) International Myeloma Working Group. International uniform response criteria for multiple myeloma. Leukemia 20:1467–1473

    Article  PubMed  CAS  Google Scholar 

  9. Blade J, Rosinol L, Cibeira MT (2008) Prognostic factors for multiple myeloma in the era of novel agents. Ann Oncol 7:117–120

    Google Scholar 

  10. Sarraf KM, Belcher E, Raevsky E, Nicholson AG, Goldstraw P, Lim E (2009) Neutrophil/lymphocyte ratio and its association with survival after complete resection in non-small cell lung cancer. J Thorac Cardiovasc Surg 137:425–428

    Article  PubMed  Google Scholar 

  11. Schmidt H, Suciu S, Punt CJ, Gore M, Kruit W, Patel P et al (2007) Pretreatment levels of peripheral neutrophils and leukocytes as independent predictors of overall survival in patients with American Joint Committee on Cancer Stage IV Melanoma: results of the EORTC 18951 Biochemotherapy Trial. J Clin Oncol 25:1562–1569

    Article  PubMed  CAS  Google Scholar 

  12. Coussens LM, Werb Z (2002) Inflammation and cancer. Nature 420:860–867

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  13. Balkwill F, Mantovani A (2001) Inflammation and cancer: back to Virchow? Lancet 357:539–545

    Article  PubMed  CAS  Google Scholar 

  14. Liu H, Tabuchi T, Takemura A, Kasuqa T, Motohashi G, Hiraishi K et al (2008) The granulocyte/lymphocyte ratio as an independent predictor of tumor growth, metastasis and progression: its clinical applications. Mol Med Rep 1:699–704

    PubMed  CAS  Google Scholar 

  15. Wang S, Zhang Z, Fang F, Gao X, Sun W, Liu H (2011) The neutrophil/lymphocyte ratio is an independent prognostic indicator in patients with bone metastasis. Oncol Lett 2:735–740

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  16. McMillan DC, Canna K, McArdle CS (2003) Systemic inflammatory response predicts survival following curative resection of colorectal cancer. Br J Surg 90:215–219

    Article  PubMed  CAS  Google Scholar 

  17. Bataille R, Boccadoro M, Klein B, Durie B, Pileri A (1992) C-reactive protein and beta-2 microglobulin produce a simple and powerful myeloma staging system. Blood 80:733–737

    PubMed  CAS  Google Scholar 

  18. Kleber M, Ihorst G, Descheler B, Jakob C, Liebisch P, Koch B et al (2009) Detection of renal impairment as one specific comorbidity factor in multiple myeloma: multicenter study in 198 consecutive patients. Eur J Haematol 83:519–527

    Article  PubMed  CAS  Google Scholar 

  19. Andrew D, Giampaolo M (2012) Myeloma kidney: advances in molecular mechanisms of acute kidney injury open novel therapeutic opportunities. Nephrol Dial Transplant 27:3713–3718

    Article  Google Scholar 

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None of the authors declare any financial and personal relationships with other people or organizations that could inappropriately influence (bias) the present work.

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Correspondence to Engin Kelkitli.

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Kelkitli, E., Atay, H., Çilingir, F. et al. Predicting survival for multiple myeloma patients using baseline neutrophil/lymphocyte ratio. Ann Hematol 93, 841–846 (2014). https://doi.org/10.1007/s00277-013-1978-8

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  • DOI: https://doi.org/10.1007/s00277-013-1978-8

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