Case Control Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 16, 2022; 10(14): 4380-4394
Published online May 16, 2022. doi: 10.12998/wjcc.v10.i14.4380
Significance of preoperative peripheral blood neutrophil-lymphocyte ratio in predicting postoperative survival in patients with multiple myeloma bone disease
Zi-Yu Xu, Xing-Chen Yao, Xiang-Jun Shi, Xin-Ru Du
Zi-Yu Xu, Xing-Chen Yao, Xin-Ru Du, Department of Orthopedics, Beijing Chao-Yang Hospital, Beijing 100020, China
Xiang-Jun Shi, Department of Hematology, Beijing Chao-Yang Hospital, Beijing 100020, China
Author contributions: Xu ZY drafted and revised the manuscript, and contributed to the data collection and drafting of the manuscript; Yao XC and Shi XJ contributed to the data analysis and interpretation; Du XR and Xu ZY contributed to the conception of the article and manuscript revision; all authors read and approved the final manuscript.
Supported by the Municipal Natural Science Foundation of Beijing of China, No. 7192071.
Institutional review board statement: The study was reviewed and approved by Beijing Chao-Yang Hospital Human Research Ethics Committee.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin-Ru Du, PhD, Professor, Department of Orthopedics, Beijing Chao-Yang Hospital, No. 8 Gongren Tiyuguannan Road, Chaoyang District, Beijing 100020, China. duxinru@163.com
Received: August 29, 2021
Peer-review started: August 29, 2021
First decision: December 17, 2021
Revised: December 30, 2021
Accepted: March 25, 2022
Article in press: March 25, 2022
Published online: May 16, 2022
Processing time: 256 Days and 21.2 Hours
Abstract
BACKGROUND

The neutrophil-lymphocyte ratio (NLR) is often used to predict a poor prognosis in patients with tumors. This study investigated the preoperative peripheral blood NLR in predicting postoperative survival (POS) in patients with multiple myeloma bone disease (MMBD).

AIM

To evaluate whether NLR can be used to predict the prognosis of MMBD patients after surgery.

METHODS

The clinical data of 82 MMBD patients who underwent surgical treatments in Beijing Chao-yang Hospital were collected. The NLR was obtained from the absolute number of neutrophils and lymphocytes, calculated by the number of neutrophils and divided by the number of lymphocytes. The peripheral blood lymphocyte percentage was used as the major marker to analyze the change in characteristics of the immune statuses of multiple myeloma patients.

RESULTS

The NLR cut-off values of NLR ≥ 3 patients and NLR ≥ 4 patients were significantly correlated with POS. The 3- and 5-year cumulative survival rates of the high NLR group (NLR ≥ 3 patients) were 19.1% and 0.0%, respectively, which were lower than those of the low NLR group (NLR < 3 patients) (67.2% and 48.3%) (P = 0.000). In the high NLR group, POS (14.86 ± 14.28) was significantly shorter than that in the low NLR group (32.68 ± 21.76). Univariate analysis showed that the lymphocyte percentage 1 wk after the operation (19.33 ± 9.08) was significantly lower than that before the operation (25.72 ± 11.02). Survival analysis showed that postoperative chemotherapy, preoperative performance status and preoperative peripheral blood NLR ≥ 3 were independent risk factors for POS.

CONCLUSION

The preoperative peripheral blood NLR can predict POS in MMBD patients. MMBD patients with a high preoperative NLR (NLR ≥ 3) showed poor prognosis.

Keywords: Multiple myeloma bone disease; Neutrophil-lymphocyte ratio; Lymphocyte percentage; Postoperative survival

Core Tip: The clinical data of 82 multiple myeloma bone disease (MMBD) patients who underwent operations in our hospital were collected. By observing the change characteristics of neutrophil-lymphocyte ratio (NLR) at different stages after the operation, to make a preliminary analysis of the effect of the operation on the immune status of multiple myeloma patients and study the prognostic value of peripheral blood NLR in predicting the treatment of MMBD. Data showed that NLR was significant for the prediction of the postoperative survival (POS) of MMBD patients treated with the operation, and MMBD patients with high preoperative NLR (NLR ≥ 3) had a poorer prognosis and shorter POS.