Limited Prognostic Value of Pretreatment Neutrophil-to-Lymphocyte Ratios in Elderly Patients with Multiple Myeloma.

BACKGROUND: Recent studies reported neutrophil to lymphocyte ratio (NLR) as a predictor of overall survival (OS) in multiple myeloma (MM). However, the role of NLR at diagnosis in elderly patients with MM has been less explored. Therefore, we aimed to investigate the relationships between NLR and prognosis in elderly patients with MM.

METHODS: We retrospectively analyzed the data for 76 newly diagnosed elderly MM patients between January 1, 2007 and September 31, 2015. Seventy-six age- and gender-matched healthy controls were also included in the study.

RESULTS: NLR was significantly higher in MM patients than the control group (2.9 ± 2.29 vs. 1.88 ± 0.54, respectively; p < 0.0001). Patients with a NLR < 2 at diagnosis had slightly better OS when compared to those with a NLR ≥ 2 (41 and 36 months, respectively), but the differences were not statistically significant. The elevated NLR did not predict response to initial therapy. Patients were regrouped into the bortezomib group and the non-bortezomib group. In the bortezomib group, notably the OS was borderline significantly longer in the patients with NLR < 2 when compared to those with NLR ≥ 2 (48 months vs. 25 months, p = 0.041). In the multivariate analysis, ISS III stage and high lactate dehydrogenase levels were significantly associated with OS.

CONCLUSIONS: We found NLR had no effect on prognosis in newly diagnosed elderly MM patients. Further studies focused on this subject are warranted.