A Nomogram Based on Circulating Inflammatory Factors for Predicting Prognosis of Newly Diagnosed Multiple Myeloma Patients

被引:0
作者
Wang, Mowang [1 ,2 ,3 ,4 ]
Yue, Xiaoyan [5 ]
Ding, Yingying [5 ]
Cai, Zhen [1 ,4 ]
Xiao, Haowen [5 ]
Huang, He [1 ,2 ,3 ,4 ]
He, Jingsong [1 ,4 ]
机构
[1] Zhejiang Univ, Affiliated Hosp 1, Bone Marrow Transplantat Ctr, Sch Med, 79 Qingchun Rd, Hangzhou 310006, Zhejiang, Peoples R China
[2] Zhejiang Univ, Med Ctr, Liangzhu Lab, Hangzhou, Zhejiang, Peoples R China
[3] Zhejiang Univ, Inst Hematol, Hangzhou, Zhejiang, Peoples R China
[4] Zhejiang Prov Engn Lab Stem Cell & Immun Therapy, Hangzhou, Zhejiang, Peoples R China
[5] Zhejiang Univ, Sir Run Run Shaw Hosp, Sch Med, Dept Hematol & Cell Therapy, Hangzhou, Zhejiang, Peoples R China
基金
中国国家自然科学基金;
关键词
multiple myeloma; neutrophil to lymphocyte ratio; platelet to lymphocyte ratio; lymphocyte to monocyte ratio; IL nomogram; TO-LYMPHOCYTE RATIO; INTERNATIONAL STAGING SYSTEM; POOR-PROGNOSIS; IL-10; LEVELS; INTERLEUKIN-10; CANCER;
D O I
10.2147/JIR.S495284
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Purpose: The growth and survival of multiple myeloma (MM) cells depend heavily on bone marrow microenvironment, where inflammation emerges as a significant feature and is commonly associated with unfavorable prognosis in MM. Our previous study and other published studies have shown that MM patients with higher neutrophil-to-lymphocyte ratio (NLR) or interleukin (IL)-10 (IL-10), lower lymphocyte-to-monocyte ratio (LMR) or platelet-to-lymphocyte ratio (PLR) frequently have inferior overall survival (OS) independent of current risk- stratification markers. Nevertheless, whether specific inflammation-related markers have prognostic value for MM patients remains elusive. Patients and methods: We retrospectively analyzed the clinical data of 452 newly diagnosed MM (NDMM) patients treated in our center from May 2013 to June 2022. Cox regression analysis and least absolute shrinkage and selector operation (LASSO) were performed to establish the predictive nomograms for survival outcomes in the training cohort, and the nomograms were validated by calibration curves in the validation cohort. Results: The best cutoff values of NLR, LMR, PLR, and IL-10 were 4.44, 4.0, 100, and 1.42pg/mL, respectively. We established a nomogram model after LASSO Cox and multivariate Cox regression analysis. The nomogram model exhibited acceptable discrimination, with C-index values of 0.777, 0.714, and 0.71 in the training cohort, validation cohort, and entire cohort, respectively, which was significantly higher than the C-indices of the three most extensively used staging systems for NDMM (D-S, ISS, and R-ISS). All calibration curves revealed good consistency between the predictive and actual survival outcomes. Patients were divided into high-risk and low-risk groups based on their total nomogram scores, with a threshold of 106.2, where the median OS of patients in the high-risk group was significantly shorter than that of patients in the low-risk group. Conclusion: The proposed nomogram based on circulating inflammatory factors is an inexpensive, widely available, and easily interpretable risk-stratification tool for NDMM patients.
引用
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页码:2077 / 2090
页数:14
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