Myeloma prognostic index at diagnosis might be a prognostic marker in patients newly diagnosed with multiple myeloma.
OBJECTIVE
The aims of this study were to identify the value of inflammatory markers as pretreatment prognostic factors for patients with multiple myeloma (MM) and to estimate the value of a prognostic index including these markers at diagnosis.


METHODS
A total of 273 newly diagnosed MM patients undergoing active treatment were analyzed in this study. The prognostic values for survival of the pretreatment inflammatory markers were investigated. A myeloma prognostic index (MPI) was derived using prognostic factors determined to be independently significant on multivariate analysis.


RESULTS
A high pretreatment neutrophil-lymphocyte ratio (NLR), low platelet count, and high C-reactive protein (CRP) level had independently unfavorable significance for overall survival (OS). The MPI was derived based on these factors. Per the MPI, 1 point each was assigned to high NLR, low platelet count, and high CRP. Risk categories were stratified into low- (score 0), intermediate- (score 1), and high-risk (score 2 or 3) groups. The MPI demonstrated independent statistical significance for OS on multivariate analysis ([intermediate: hazard ratio (HR), 1.91; 95% confidence interval (CI), 1.12 to 3.24] and [high: HR, 3.37; 95% CI, 2.00 to 5.69];p< 0.001). Moreover, this significance could be observed regardless of age, renal function, and exposure to novel agents. In addition, the International Staging System risk group could be further significantly stratified using the MPI.


CONCLUSIONS
The MPI, consisting of pretreatment inflammatory markers, NLR, platelet count, and CRP, might be effective in predicting the survival of newly diagnosed MM patients undergoing active treatment.
Division of Oncology and Hematology, Department of Internal Medicine, Korea University School of Medicine, Seoul, Korea.
Dae Sik
DS
Kim
Division of Oncology and Hematology, Department of Internal Medicine, Korea University School of Medicine, Seoul, Korea.
Eun Sang
ES
Yu
Division of Oncology and Hematology, Department of Internal Medicine, Korea University School of Medicine, Seoul, Korea.
Ka-Won
KW
Kang
Division of Oncology and Hematology, Department of Internal Medicine, Korea University School of Medicine, Seoul, Korea.
Se Ryeon
SR
Lee
Division of Oncology and Hematology, Department of Internal Medicine, Korea University School of Medicine, Seoul, Korea.
Yong
Y
Park
Division of Oncology and Hematology, Department of Internal Medicine, Korea University School of Medicine, Seoul, Korea.
Hwa Jung
HJ
Sung
Division of Oncology and Hematology, Department of Internal Medicine, Korea University School of Medicine, Seoul, Korea.
Chul Won
CW
Choi
Division of Oncology and Hematology, Department of Internal Medicine, Korea University School of Medicine, Seoul, Korea.
Byung Soo
BS
Kim
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000175:diagnosis* / Q000276:immunology / Q000401:mortality; D010976:Platelet Count; D011379:Prognosis; D056910:Republic of Korea / Q000453:epidemiology; D012720:Severity of Illness Index
D002097:C-Reactive Protein
C-reactive protein; Multiple myeloma; Neutrophil-lymphocyte ratio; Platelet count; Prognosis