Contributions
Abstract: PB2178
Type: Publication Only
Background
The neutrophil-lymphocyte ratio (NLR) has been recently identified for multiple myeloma (MM) as prognostic factor. There are several trials and one meta-analysis confirm it. The NLR is neutrophil count (cells/µL) divided by lymphocyte count (cells/µL) in common blood count.
Aims
In our research we studied the NLR prognostic significance for overall survival (OS) and for distribution by Durie-Salmon stages of patients with MM. We checked hypothesis that NLR can serve as a negative prognostic immune biomarker in newly diagnosed MM.
Methods
Our study included 314 patients with newly diagnosed MM at the Kirov Research Institute of Hematology and Blood Transfusion from 1990–2015. All patients fulfilled the IMWG criteria for symptomatic MM. The correlation of NLR with various parameters was assessed with ANOVA corrected by Turkey HSD test for multiple comparisons. For assessment categorical parameters we used Kruskal-Wallis rank test. The Cox proportional hazards model, Wilcoxon and log-rank tests for comparison survival curves was used to evaluate NLR at diagnosis as a prognostic factor for OS. Statistical analysis was performed using R language (v 3.4.3). A p-value of <0.05 was considered statistically significant.
Results
In our group, the median age was 64 years old (range: 29–90) and 190 patients (60%) were female. Overall, 179 patients (57%) had IgG type, 74 (23%) had IgA type, 43 (14%) had light chain disease and 15 (5%) had non-secretory MM. The MM type of 3 (1%) patients was unknown. The median NLR at diagnosis was 1.6. The cutoff point of NLR ⩾2.6 that yielded the greatest differential to segregate cohorts, was based on the analyzed at different cutoff points from the long-rank test. At the time of this study, 256 (82%) patients had died. The median of OS in all group was 35 months, 5-year OS – 30%. We found that patients with stage IIB and IIIB by Durie-Salmon had more superior average NLR level versus patients with stage IA, IIA and IIIA (ANOVA test, p<0.0001). During multiple comparative analysis patients with A and B subclasses differed among themselves by NLR level (Turkey HSD test, p<0.05). In this regard we compare medians in this group because they did not have normal distribution. The median of NLR level in patients in B stages by Durie-Salmon was higher than among patients with A stages (2.45 versus 1.45, Kruskal-Wallis test, p<0.0001). Also, patients with baseline NLR ⩾2.6 had shorter median OS (28 months versus 40 months, respectively; HR = 1.38, 95% CI: 1.05–1.8, p-value=0.023; Wilcoxon test, p = 0.008).
Conclusion
The MM patients with higher NLR (⩾2.6) are more likely to have poorer prognosis by OS than those with lower NLR. Also, in patients with B stages (IIB or IIIB) by Durie-Salmon with high creatinine level (⩾2mg/dL) the average NRO level is higher than those, who don’t have myeloma nephropathy.
Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical
Keyword(s): Multiple Myeloma, Prediction, prognosis
Abstract: PB2178
Type: Publication Only
Background
The neutrophil-lymphocyte ratio (NLR) has been recently identified for multiple myeloma (MM) as prognostic factor. There are several trials and one meta-analysis confirm it. The NLR is neutrophil count (cells/µL) divided by lymphocyte count (cells/µL) in common blood count.
Aims
In our research we studied the NLR prognostic significance for overall survival (OS) and for distribution by Durie-Salmon stages of patients with MM. We checked hypothesis that NLR can serve as a negative prognostic immune biomarker in newly diagnosed MM.
Methods
Our study included 314 patients with newly diagnosed MM at the Kirov Research Institute of Hematology and Blood Transfusion from 1990–2015. All patients fulfilled the IMWG criteria for symptomatic MM. The correlation of NLR with various parameters was assessed with ANOVA corrected by Turkey HSD test for multiple comparisons. For assessment categorical parameters we used Kruskal-Wallis rank test. The Cox proportional hazards model, Wilcoxon and log-rank tests for comparison survival curves was used to evaluate NLR at diagnosis as a prognostic factor for OS. Statistical analysis was performed using R language (v 3.4.3). A p-value of <0.05 was considered statistically significant.
Results
In our group, the median age was 64 years old (range: 29–90) and 190 patients (60%) were female. Overall, 179 patients (57%) had IgG type, 74 (23%) had IgA type, 43 (14%) had light chain disease and 15 (5%) had non-secretory MM. The MM type of 3 (1%) patients was unknown. The median NLR at diagnosis was 1.6. The cutoff point of NLR ⩾2.6 that yielded the greatest differential to segregate cohorts, was based on the analyzed at different cutoff points from the long-rank test. At the time of this study, 256 (82%) patients had died. The median of OS in all group was 35 months, 5-year OS – 30%. We found that patients with stage IIB and IIIB by Durie-Salmon had more superior average NLR level versus patients with stage IA, IIA and IIIA (ANOVA test, p<0.0001). During multiple comparative analysis patients with A and B subclasses differed among themselves by NLR level (Turkey HSD test, p<0.05). In this regard we compare medians in this group because they did not have normal distribution. The median of NLR level in patients in B stages by Durie-Salmon was higher than among patients with A stages (2.45 versus 1.45, Kruskal-Wallis test, p<0.0001). Also, patients with baseline NLR ⩾2.6 had shorter median OS (28 months versus 40 months, respectively; HR = 1.38, 95% CI: 1.05–1.8, p-value=0.023; Wilcoxon test, p = 0.008).
Conclusion
The MM patients with higher NLR (⩾2.6) are more likely to have poorer prognosis by OS than those with lower NLR. Also, in patients with B stages (IIB or IIIB) by Durie-Salmon with high creatinine level (⩾2mg/dL) the average NRO level is higher than those, who don’t have myeloma nephropathy.
Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical
Keyword(s): Multiple Myeloma, Prediction, prognosis