The role of inflammatory-nutritional indicators in predicting the prognosis and early mortality of newly diagnosed multiple myeloma patients
Objective:To investigate the prognostic role of inflammation-nutrition indicators in predicting the prognosis and early mortality of newly diagnosed multiple myeloma(NDMM)patients.Methods:The clinical data of 161 patients with NDMM from August 2015 to February 2022 at the Affiliated Hospital of Xuzhou Medical U-niversity were retrospectively analyzed.The clinical data included age,gender,hemoglobin,albumin,lactate de-hydrogenase(LDH),creatinine,blood β2-microglobulin,tumor burden,CD27 and CD56 expression on plasma cell surface,cytogenetics detecting by fluorescence in situ hybridization,presence of extramedullary disease,sple-nomegaly,prognostic nutritional index(PNI),inflammation indicators monocyte-lymphocyte ratio(MLR),sys-temic immune inflammation index,and treatment regimens.Single-factor and multi-factor Cox proportional haz-ards regression analyses were conducted on baseline characteristics at initial diagnosis and treatment regimens to explore factors influencing prognosis;single-factor and multi-factor logistic regression methods were used to ana-lyze factors affecting early mortality.Results:Univariate Cox regression analysis showed that hemoglobin,LDH,PNI,MLR,and CD27 were factors affecting patients'progression-free survival(P＜0.05);age,LDH,PNI,MLR,CD27 and CD56 were factors affecting patients'overall survival(P＜0.05).Multivariate Cox regression a-nalysis showed that high LDH,high MLR,and plasma cell surface CD27 negativity were independent risk factors affecting progression-free survival;age≥65 years,high LDH,low PNI,high MLR,and 1q21 amplification were independent adverse prognostic factors affecting overall survival(P＜0.05).The occurrence rates of death within 12 months(EM12)and 24 months(EM24)were 11.5％and 24.2％,respectively.Agc≥65 years and plasma cell surface CD56 negativity were independent factors for both EM12 and EM24;high LDH was an independent factor for EM12;high MLR and low PNI were independent factors for EM24(P＜0.05).Conclusion:Low PNI and high MLR are independent risk factors affecting the prognosis of NDMM patients and may indicate an increased risk of early mortality for patients.
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