Myeloma prognostic index at diagnosis might be a prognostic marker in patients newly diagnosed with multiple myeloma

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Abstract

Background/Aims: 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.

Original languageEnglish
Pages (from-to)711-721
Number of pages11
JournalKorean Journal of Internal Medicine
Volume32
Issue number4
DOIs
Publication statusPublished - 2017 Jul 1

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Multiple Myeloma
Platelet Count
C-Reactive Protein
Neutrophils
Survival
Lymphocytes
Multivariate Analysis
Confidence Intervals
Kidney
Therapeutics

Keywords

  • C-reactive protein
  • Multiple myeloma
  • Neutrophil-lymphocyte ratio
  • Platelet count
  • Prognosis

ASJC Scopus subject areas

  • Internal Medicine

Cite this

@article{1db4defde8ff437591e4c1b3da3ad601,
title = "Myeloma prognostic index at diagnosis might be a prognostic marker in patients newly diagnosed with multiple myeloma",
abstract = "Background/Aims: 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.",
keywords = "C-reactive protein, Multiple myeloma, Neutrophil-lymphocyte ratio, Platelet count, Prognosis",
author = "Kim, {Dae Sik} and Yu, {Eun Sang} and Kang, {Ka Won} and Lee, {Se Ryeon} and Yong Park and Sung, {Hwa Jung} and Choi, {Chul Won} and Kim, {Byung Soo}",
year = "2017",
month = "7",
day = "1",
doi = "10.3904/kjim.2016.054",
language = "English",
volume = "32",
pages = "711--721",
journal = "Korean Journal of Internal Medicine",
issn = "0494-4712",
publisher = "Korean Association of Internal Medicine",
number = "4",

}

TY - JOUR

T1 - Myeloma prognostic index at diagnosis might be a prognostic marker in patients newly diagnosed with multiple myeloma

AU - Kim, Dae Sik

AU - Yu, Eun Sang

AU - Kang, Ka Won

AU - Lee, Se Ryeon

AU - Park, Yong

AU - Sung, Hwa Jung

AU - Choi, Chul Won

AU - Kim, Byung Soo

PY - 2017/7/1

Y1 - 2017/7/1

N2 - Background/Aims: 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.

AB - Background/Aims: 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.

KW - C-reactive protein

KW - Multiple myeloma

KW - Neutrophil-lymphocyte ratio

KW - Platelet count

KW - Prognosis

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DO - 10.3904/kjim.2016.054

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SP - 711

EP - 721

JO - Korean Journal of Internal Medicine

JF - Korean Journal of Internal Medicine

SN - 0494-4712

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