Elevated neutrophil-to-lymphocyte ratio and monocyte-to-lymphocyte ratio and decreased platelet-to-lymphocyte ratio are associated with poor prognosis in multiple myeloma

// Lihui Shi 1, * , Xiaoqi Qin 1, 2, * , Huijun Wang 1 , Yonghui Xia 1 , Yuanyuan Li 1 , Xuejing Chen 1 , Lei Shang 1 , Yu-Tzu Tai 3 , Xiaoyan Feng 1 , Prakrati Acharya 4 , Chirag Acharya 3 , Yan Xu 1 , Shuhui Deng 1 , Mu Hao 1 , Dehui Zou 1 , Yaozhong Zhao 1 , Kun Ru 1 , Lugui Qiu 1 , Gang An 1 1 State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Tianjin, China 2 Department of Hematology, The Second Hospital of Shanxi Medical University, Taiyuan, China 3 LeBow Institute for Myeloma Therapeutics and Jerome Lipper Center for Multiple Myeloma Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA 4 Mount Auburn Hospital, Harvard Medical School, Cambridge, MA, USA * These authors contributed equally to this work Correspondence to: Gang An, email: angang@ihcams.ac.cn Kun Ru, email: kunru@yahoo.com Keywords: multiple myeloma, inflammation mark Received: May 06, 2016      Accepted: September 20, 2016      Published: November 12, 2016 ABSTRACT Elevated inflammatory markers are associated with poor outcomes in various types of cancers; however, their clinical significance in multiple myeloma (MM) have seldom been explored. This study investigated the prognostic relevance of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) in MM. Totally 559 MM patients were included in this study. NLR, PLR and MLR were calculated from whole blood counts prior to therapy. Kaplan-Meier curves and multivariate Cox proportional models were used for the evaluation of the survival. It has shown that newly diagnosed MM patients were characterized by high NLR and MLR. Elevated NLR and MLR and decreased PLR were associated with unfavorable clinicobiological features. Applying cut-offs of 4 (NLR), 100 (PLR) and 0.3 (MLR), elevated NLR, MLR and decreased PLR showed a negative impact on outcome. Importantly, elevated NLR and decreased PLR were independent prognostic factors for progression-free survival. Thus, elevated NLR and MLR, and decreased PLR predict poor clinical outcome in MM patients and may serve as the cost-effective and readily available prognostic biomarkers.