Prognostic significance of neutrophil-lymphocyte ratio in multiple myeloma patients

Background: Increased neutrophil-to-lymphocyte ratio (NLR) has been proposed to predict poor prognosis in many cancer types. However, the prognostic value of NLR in multiple myeloma (MM) remains largely unknown. This study aimed to investigate whether NLR is an independent predictor of MM. Methods: Data were collected retrospectively from 136 patients who were diagnosed with MM and subjected to bortezomib-thalidomide-dexamethasone chemotherapy at the Nanjing Drum Tower Hospital from 2008 to 2016. The association between NLR and clinical characteristics was evaluated. The prognostic value of NLR was investigated by Kaplan-Meier and Cox proportional hazards method. All statistical tests were two-sided. Results: The cutoff value of NHL was set at 2. The OS and progression-free survival (PFS) of the patients with high NLR were shorter than those with low NLR (chi(2)=6.503, P=0.014 and chi(2)=6.087, P=0.011 respectively). Multivariate analysis further showed that increased NLR was an independent predictive value of poor OS [hazard ratio (HR)=0.098, 95% confidence interval (CI): 0.012-0.783, P=0.028] and PFS (HR=0.052, 95% CI: 0.005-0.596, P=0.018). Conclusions: NLR can be used as an independent prognostic predictor of MM.