Decreased peripheral blood lymphocyte to monocyte ratio, platelet to lymphocyte ratio, platelet to monocyte ratio and platelet to albumin ratio predict poor survival in newly diagnosed Multiple Myeloma patients

Abstract

Abstract Background. Multiple myeloma (MM) is a clonal malignant tumor with abnormal proliferation of Plasma cell, ranking second in the incidence rate of common malignant tumors in the blood system. The clinical manifestations, treatment responses, and prognosis of patients are highly heterogeneous. Therefore, optimal strategies for identifying high-risk patients are urgently needed. Materials and Methods. We retrospectively studied 145 newly diagnosed MM patients from January 2013 to December 2020 and analyzed the relationship between peripheral blood lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR), platelet-monocyte ratio (PMR), platelet-albumin ratio (PAR) and prognosis. Results. The receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value based on survival rate. It was found that patients with MM with LMR ≤ 2.55, PLR ≤ 117, PMR ≤ 181 and PAR ≤ 3.38 had inferior overall survival (OS). In multivariate analysis, LMR ≤ 2.55 (HR = 0.243, 95% CI 0.099–0.596, p = 0.002), PLR ≤ 117 (HR = 0.222, 95% CI 0.072–0.680, p = 0.008), PAR ≤ 3.38 (HR = 0.293, 95% CI 0.107–0.804, p = 0.017) and Serum creatinine ≥ 177umol/l (HR = 2.599, 95% CI 1.086–6.218, p = 0.032) were independently associated with short survival. The more items that simultaneously meet LMR ≤ 2.55, PLR ≤ 117, PMR ≤ 181 and PAR ≤ 3.38, the worse the prognosis of the patients (P = 0.000). The 2-year OS of patients with reduced four ratios was only 32%, and the 3-year OS was only 16%. Conclusion. The pre treatment LMR, PLR, PMR and PAR of MM patients are closely related to their prognosis. Moreover, LMR, PMR, and PAR are independent prognostic indicators for MM patients. We can use them for initial screening and stratification of MM patients. It is simple, convenient and accurate to screen out patients with short lives, and formulate personalized treatment strategies.