The Predictive Role of the Neutrophil/Lymphocyte Ratio in Survival with Multiple Myeloma: A Single Center Experience.

BACKGROUND: Recent studies have shown a positive correlation between tumor-related immune response markers and the poor outcome in solid tumors. In this study, we aimed to investigate the neutrophil/lymphocyte ratio (NLR) in multiple myeloma. To the best of our knowledge, this would be the second report concerning this topic. METHODS: We retrospectively reviewed the data for 52 multiple myeloma patients. The patients were grouped using the baseline NLR as NLR ≤ 1.72 and NLR > 1.72 using receiver operating characteristic analysis to determine a cut off. We compared the two groups in terms of both the known prognostic factors of the myeloma and the overall survival (OS). RESULTS: Our study showed that NLR is associated with C-reactive protein and ß2 microglobulin (P = 0.02 and P = 0.001, respectively). The patients with NLR > 1.72 had significantly worse stages, performance status, and kidney functions. The whole group's OS was estimated as 35.1 months while the patients with lower NLR had better OS when compared with those with NLR > 1.72 (42.75 and 26.14 months, respectively, P: 0.04). CONCLUSION: Neutrophil/lymphocyte ratio, which is associated with stage, performance status, and kidney functions, can be used in daily practice as a predictor for survival in multiple myeloma. Simply adding NLR to the routine charts may enrich our data for larger studies.

Comparative Evaluation of Common Comorbidity Scores and Freiburger Comorbidity Index as Prognostic Variables in a Real Life Multiple Myeloma Population.

Multiple myeloma (MM) is a disease of the geriatric population with a median age at diagnosis of 69 years but most clinicians consider performance status and comorbidities rather than chronological age in determining prognosis and treatment. The purpose of this study was to assess whether and which comorbidity indices predict survival in a real life population of MM. We calculated Charlson Comorbidity Index (CCI), age combined Charlson index (CCI-age), Hematopoietic cell transplantation-specific comorbidity index (HCT-SCI) and Freiburger comorbidity index (FCI) retrospectively for 66 MM patients and compared their impact on treatment responses and overall survival (OS). Treatment response was significantly worse in groups with high CCI, CCI-age, HCT-SCI scales (p < 0.05), but FCI's effect on treatment response was not significant. However, while no significant relationship was determined between other comorbidity indices with OS, it was related only with FCI-CI (p = 0.006). FCI, developed in this patient group, was the only prognostic index with a significant effect on OS in the evaluation of comorbidities in MM patients with different scores, but its relationship to treatment responses was not significant contrary to other indices. While this small patient group gave us hope regarding the use of FCI in practice, multi-center studies are still required.