外周血单核细胞/淋巴细胞比值在接受硼替佐米治疗的初诊多发性骨髓瘤患者预后中的价值

董亚青; 马艳萍

doi:10.13201/j.issn.1004-2806.2019.05.012

外周血单核细胞/淋巴细胞比值在接受硼替佐米治疗的初诊多发性骨髓瘤患者预后中的价值

董亚青,
马艳萍^,

- 山西医科大学第二医院血液内科(太原, 030001)

详细信息

通讯作者: 马艳萍,E-mail:myanp18@163.com

中图分类号: R733.3

收稿日期: 2019-01-14

The value of peripheral blood mononuclear cell/lymphocyte ratio in the prognosis of newly diagnosed multiple myeloma patients treated with bortezomib

DONG Yaqing,
MA Yanping^,

- Department of Hematology, the Second Hospital of Shanxi Medical University, Taiyuan, 030001, China

More Information

Corresponding author: MA Yanping, E-mail: myanp18@163.com

Received Date: 14 January 2019

摘要

摘要: 目的：探讨外周血中性粒细胞/淋巴细胞比值（NLR）、单核细胞/淋巴细胞比值（MLR）、血小板/淋巴细胞比值（PLR）在接受硼替佐米治疗的初诊多发性骨髓瘤（MM）患者预后中的价值。方法：回顾性分析新诊断的接受硼替佐米治疗的81例MM患者的临床资料，通过受试者操作特征曲线分析确定NLR、MLR、PLR的界值，以此为标准将患者分为高值组（NLR ≥ 1.53、MLR ≥ 0.14、PLR ≥ 54.48）和低值组（NLR<1.53、MLR<0.14、PLR<54.48），然后分析治疗前不同NLR、MLR、PLR组在基线资料、总生存（OS）及无进展生存（PFS）方面的差异。生存分析采用Kaplan-Meier法，单因素分析采用Log-rank检验，多因素分析采用COX回归模型。结果：①单因素分析结果显示，单核细胞 ≥ 0.6×10⁹/L、MLR ≥ 0.14、肌酐 ≥ 177 mmol/L、DS分期Ⅲ期可能是影响患者OS的不良预后因素；单核细胞 ≥ 0.6×10⁹/L、MLR ≥ 0.14、血钙 ≥ 2.25 mmol/L、DS分期Ⅲ期可能是影响患者PFS的不良预后因素。②多因素分析结果显示，MLR和DS分期是影响患者OS和PFS的独立预后因素。③ISS各分期不同MLR组预后比较，ISS Ⅲ期不同MLR组OS差异有统计学意义（P=0.021）；ISS各分期不同MLR组PFS比较，ISS Ⅲ期不同MLR组PFS差异有统计学意义（P=0.008）。结论：本研究表明，外周血MLR是接受硼替佐米治疗的初诊MM患者的独立预后因素，且ISS Ⅲ期患者具有异质性，高MLR组ISS Ⅲ期患者预后差，低MLR组ISS Ⅲ期患者预后相对较好。
- 多发性骨髓瘤 /
- 硼替佐米 /
- 单核细胞与淋巴细胞比值 /
- 预后
Abstract: Objective: To explore the value of peripheral blood absolute neutrophil/lymphocyte ratio (NLR),absolute monocyte/lymphocyte ratio (MLR),absolute platelet/lymphocyte ratio (PLR) in the prognosis of patients with newly diagnosed multiple myeloma (MM) treated with bortezomib.Method: A retrospective analysis of the clinical data of 81 patients with multiple myeloma (MM) who were treated with bortezomib.The NLR,MLR and PLR thresholds were determined by ROC analysis,and the patients were divided into high value groups (NLR ≥ 1.53,MLR ≥ 0.14,PLR ≥ 54.48) and low value groups (NLR<1.53,MLR<0.14,PLR<54.48),and then we analyzed the differences in clinical indicators,overall survival (OS) and progression-free survival (PFS) between different NLR,MLR and PLR groups before treatment.Survival analysis was performed using the Kaplan-Meier method,single factor analysis using Log-rank test and multivariate analysis using COX regression model.Result: ①Univariate analysis showed that mononuclear cells ≥ 0.6×10⁹/L,MLR ≥ 0.14,creatinine ≥ 177 mmol/L and DS stage Ⅲ may be adverse prognostic factors affecting OS;monocytes ≥ 0.6×10⁹/L,MLR ≥ 0.14,blood calcium ≥ 2.25 mmol/L and DS stage Ⅲ may be poor prognostic factors affecting PFS.②Multivariate analysis showed that MLR and DS staging were independent prognostic factors affecting OS and PFS.③Prognosis ratio of different MLR groups in different stages of ISS showed that there was significant difference in OS of different MLR groups in ISS Ⅲ stage (P=0.021).The PFS comparison of different MLR groups in ISS stages showed that there was significant difference in PFS of different MLR groups in ISS Ⅲ stage (P=0.008).Conclusion: This study showed that peripheral blood MLR is an independent prognostic factor for newly diagnosed MM patients treated with bortezomib,and ISS Ⅲ patients are heterogeneous,the prognosis of patients with ISS Ⅲ in the high MLR group is poor,and the prognosis in patients with ISS Ⅲ in the low MLR group is relatively good.
- multiple myeloma /
- bortezomib /
- monocyte to lymphocyte ratio /
- prognosis

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