Neutrophil to lymphocyte ratio (NLR) impact on the progression-free survival and overall survival of multiple myeloma patients treated with high-dose chemotherapy and autologous stem cell transplantation

Abstract

High-dose chemotherapy with autologous stem-cell transplantation (ASCT) remains the standard of care in multiple myeloma (MM) patients. This retrospective study aimed to assess the impact of neutrophil-to-lymphocyte ratio (NLR) and other complete blood count (CBC)-based predictors on PFS and OS of transplant-eligible MM patients. The CBC-based biomarkers were evaluated in a single-center cohort of 176 MM patients at three time points: at the diagnosis, the time of ASCT, and +100 d after ASCT. Univariable and multivariable Cox’s regression analyses and Kaplan–Meier estimate were used in statistical analysis. NLR at ASCT (HR 1.15, 95% CI: 1.05–1.26) and hemoglobin at ASCT (HR 0.80, 95% CI: 0.68–0.94) were independent factors influencing PFS. In the model for OS, the only statistically significant factors were NLR at ASCT (HR 1.15, 95% CI: 1.04–1.27), bortezomib administration prior to ASCT (HR 0.52, 95% CI: 0.33–0.83) and age at diagnosis (HR 1.03, 95% CI: 1.00–1.06). NLR at ASCT is an independent predictive factor in MM patients undergoing ASCT.

Keywords:

• Autologous stem cell transplantation
• multiple myeloma
• neutrophil‑to‑lymphocyte ratio
• plasma cell myeloma

Acknowledgments

The authors thank Aleksandra Kotkowska and Monika Siemieniuk-Ryś for performing cytogenetic analyses.

Ethical approval

This study (RNN/424/19/KE) has been approved by the Ethics Committee of the Medical University of Lodz, in accordance with the Declaration of Helsinki.

Author contributions

Conceptualization, methodology, and writing: D.M., K.K, A.W. and W.F. Resources: D.M., K.K., M.N, E.W., M.K, M.K, M.P, E.S., A.Ś. Data curation: D.M, K.K, E.W and M.N. Review and editing: D.M, K.K, A.W. and W.F. All the authors have read and approved the manuscript for publication.

Disclosure statement

A.W.: research grants: Jazz Pharmaceuticals; honoraria: AbbVie, Astellas, BMS/Celgene, Gilead/Kite, Janssen, Novartis, Pfizer, Servier; advisory boards: AbbVie, Astellas, BerGenBio, BMS/Celgene, Gilead/Kite, Janssen, Novartis, Pfizer, Servier. The remaining authors have no conflicts of interest to declare.

Data availability statement

For materials, correspondence and requests should be addressed to D.M.

Additional information

Funding

The study was funded by the National Science Center grant number 2019/33/B/NZ5/00536 awarded to W.F.