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Cheng J, Li Q, Xiao S, Nie L, Liao J, Jiang Q, Xiang B, Zhang H, Jiang Y, Yao C. The advanced lung cancer inflammation index predicts chemotherapy response and infection risk in multiple myeloma patients receiving induction chemotherapy. Front Genet 2022; 13:1047326. [PMID: 36425070 PMCID: PMC9678942 DOI: 10.3389/fgene.2022.1047326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 10/24/2022] [Indexed: 10/13/2023] Open
Abstract
Objective: This study aims to determine the clinical significance of the advanced lung cancer inflammation index (ALI) in predicting prognosis, chemotherapy response, and infection risk in newly diagnosed multiple myeloma (MM) patients receiving induction therapy. Methods: A retrospective analysis of the clinical characteristics and laboratory data of 111 newly diagnosed MM patients from the Haematology Department of the Third Xiangya Hospital of Central South University from January 2014 to March 2020 was performed. We first determined the relationship between ALI and overall survival (OS), as well as clinical and laboratory parameters. Second, predictive factors for chemotherapy response were analysed by univariate and multivariate regression analyses. Third, univariate regression analysis of risk factors was performed using infection as the evaluable outcome. Results: Of the 111 evaluable patients, the low ALI group (<32.7) exhibited significantly poorer survival than the high ALI group (51 months versus 77 months). Multivariable analysis showed that advanced age, chemotherapy response and serum calcium level were independent prognostic factors for OS. Better chemotherapy efficacy in the high ALI group (89.3%) than in the low ALI group (42.2%) (p < 0.001) was noted. Multivariate analysis suggested that only ALI [HR: 0.110, 95% CI (0.035-0.350), p = 0.000] is an independent predictive factor in evaluating the efficiency of induction chemotherapy. Forty patients (36.04%) presented with infection after induction chemotherapy. Univariate analysis suggested that low ALI and abnormal renal function increase risk of infection in newly diagnosed MM patients. Conclusion: Our study confirmed that ALI is not only a prognostic biomarker for newly diagnosed patients, but also predicts chemotherapy efficacy in newly diagnosed MM patients receiving induction therapy.
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Affiliation(s)
- Jie Cheng
- The Third Xiangya Hospital of Central South University, Changsha, China
| | - Qianyuan Li
- The Third Xiangya Hospital of Central South University, Changsha, China
| | - Sheng Xiao
- The Third Xiangya Hospital of Central South University, Changsha, China
| | - Lu Nie
- The Third Xiangya Hospital of Central South University, Changsha, China
| | - Jianping Liao
- The Third Xiangya Hospital of Central South University, Changsha, China
| | - Qingjie Jiang
- The Third Xiangya Hospital of Central South University, Changsha, China
| | - Biyu Xiang
- The Third Xiangya Hospital of Central South University, Changsha, China
| | - Hongfei Zhang
- The Third Xiangya Hospital of Central South University, Changsha, China
| | - Yanhong Jiang
- The Third Xiangya Hospital of Central South University, Changsha, China
| | - Chenjiao Yao
- The Third Xiangya Hospital of Central South University, Changsha, China
- The First Affiliated Hospital of Hainan Medical University, Haikou, China
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Xu ZY, Yao XC, Shi XJ, Du XR. Significance of preoperative peripheral blood neutrophil-lymphocyte ratio in predicting postoperative survival in patients with multiple myeloma bone disease. World J Clin Cases 2022; 10:4380-4394. [PMID: 35663088 PMCID: PMC9125285 DOI: 10.12998/wjcc.v10.i14.4380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 12/30/2021] [Accepted: 03/26/2022] [Indexed: 02/06/2023] Open
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.
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Affiliation(s)
- Zi-Yu Xu
- Department of Orthopedics, Beijing Chao-Yang Hospital, Beijing 100020, China
| | - Xing-Chen Yao
- Department of Orthopedics, Beijing Chao-Yang Hospital, Beijing 100020, China
| | - Xiang-Jun Shi
- Department of Hematology, Beijing Chao-Yang Hospital, Beijing 100020, China
| | - Xin-Ru Du
- Department of Orthopedics, Beijing Chao-Yang Hospital, Beijing 100020, China
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Zhang X, Duan J, Wen Z, Xiong H, Chen X, Liu Y, Liao K, Huang C. Are the Derived Indexes of Peripheral Whole Blood Cell Counts (NLR, PLR, LMR/MLR) Clinically Significant Prognostic Biomarkers in Multiple Myeloma? A Systematic Review And Meta-Analysis. Front Oncol 2021; 11:766672. [PMID: 34888244 PMCID: PMC8650157 DOI: 10.3389/fonc.2021.766672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 11/08/2021] [Indexed: 12/12/2022] Open
Abstract
Background Multiple myeloma (MM) is an incurable malignant plasma cell tumor. Whole blood cell count (WBCC) derived indexes are widely used as a predictive biomarker for various types of solid and hematological malignant tumors. Our study is to evaluate its effectiveness in MM by meta-analysis. Methods Relevant literatures were retrieved from PubMed, Embase and Web of Science databases according to PRISMA guideline. All relevant parameters were extracted and combined for statistical analysis. Results Nineteen studies incorporating 3818 MM patients were eventually included in this meta-analysis. 13 studies evaluated that elevated NLR was significantly associated with poor survival outcomes (OS: HR=2.04, P<0.001; PFS: HR=1.96, P=0.003). Elevated NLR was revealed to correlate with ISS stage (ISS III VS I-II, OR=2.23, P=0.003). A total of 7 studies have shown that elevated LMR predicts a better prognosis in MM patients (OS: HR=0.57, P<0.001; PFS: HR=0.49, P<0.05), and two other studies demonstrated that increased MLR was related to poor OS/PFS (OS: HR=1.58, P<0.05; PFS: HR=1.60, P<0.05). However, in the other 6 studies including 1560 patients, the prognostic value of PLR had not been confirmed (OS: HR=0.89, P>0.05; PFS: HR=0.87, P>0.05). Conclusions The indexes NLR and LMR/MLR derived from WBCC were validated to be useful biomarkers to predict the prognosis in MM patients, but the evidence of PLR was insufficient.
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Affiliation(s)
- Xinwen Zhang
- Stem Cell Laboratory, Affiliated Hospital of Southwest Medical University, Luzhou, China.,Department of Hematology, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Jialin Duan
- Stem Cell Laboratory, Affiliated Hospital of Southwest Medical University, Luzhou, China.,Department of Hematology, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Zhenyu Wen
- Department of Orthopedics, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Hao Xiong
- Stem Cell Laboratory, Affiliated Hospital of Southwest Medical University, Luzhou, China.,Department of Hematology, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Xiaomin Chen
- Stem Cell Laboratory, Affiliated Hospital of Southwest Medical University, Luzhou, China.,Department of Hematology, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Yang Liu
- Stem Cell Laboratory, Affiliated Hospital of Southwest Medical University, Luzhou, China.,Department of Hematology, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Kunyu Liao
- Stem Cell Laboratory, Affiliated Hospital of Southwest Medical University, Luzhou, China.,Department of Hematology, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Chunlan Huang
- Stem Cell Laboratory, Affiliated Hospital of Southwest Medical University, Luzhou, China.,Department of Hematology, Affiliated Hospital of Southwest Medical University, Luzhou, China
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Zhaoyun L, Rong F. Predictive Role of Immune Profiling for Survival of Multiple Myeloma Patients. Front Immunol 2021; 12:663748. [PMID: 34290698 PMCID: PMC8287504 DOI: 10.3389/fimmu.2021.663748] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 06/23/2021] [Indexed: 01/10/2023] Open
Abstract
Despite new efficacy drugs and cell therapy have been used for multiple myeloma (MM) patients, some patients will relapse over time. We wonder the immune system play a vital role as well as MM cell during the development of disease. It is clear that the characteristic of myeloma cell is associated with the survival of MM patients. However, the link between the immune profiling and the prognosis of the disease is still not entirely clear. As more study focus on the role of immunity on multiple myeloma pathogenesis. There are plenty of study about the predictive role of immunity on the survival of multiple myeloma patients. Up to mow, the majority reviews published have focused on the immunotherapy and immune pathogenesis. It is indispensable to overlook the predictive role of immunity on multiple myeloma patients. Here, we give a review of vital previous works and recent progress related to the predictive role of immune profiling on multiple myeloma, such as absolute lymphocyte count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, lymphocytes and cytokines.
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Affiliation(s)
- Liu Zhaoyun
- Department of Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Fu Rong
- Department of Hematology, Tianjin Medical University General Hospital, Tianjin, China
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Romano A, Parrinello NL, Simeon V, Puglisi F, La Cava P, Bellofiore C, Giallongo C, Camiolo G, D'Auria F, Grieco V, Larocca F, Barbato A, Cambria D, La Spina E, Tibullo D, Palumbo GA, Conticello C, Musto P, Di Raimondo F. High-density neutrophils in MGUS and multiple myeloma are dysfunctional and immune-suppressive due to increased STAT3 downstream signaling. Sci Rep 2020; 10:1983. [PMID: 32029833 PMCID: PMC7005058 DOI: 10.1038/s41598-020-58859-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 01/06/2020] [Indexed: 02/07/2023] Open
Abstract
To understand neutrophil impairment in the progression from MGUS through active MM, we investigated the function of mature, high-density neutrophils (HDNs), isolated from peripheral blood. In 7 MM, 3 MGUS and 3 healthy subjects by gene expression profile, we identified a total of 551 upregulated and 343 downregulated genes in MM-HDN, involved in chemokine signaling pathway and FC-gamma receptor mediated phagocytosis conveying in the activation of STAT proteins. In a series of 60 newly diagnosed MM and 30 MGUS patients, by flow-cytometry we found that HDN from MM, and to a lesser extend MGUS, had an up-regulation of the inducible FcγRI (also known as CD64) and a down-regulation of the constitutive FcγRIIIa (also known as CD16) together with a reduced phagocytic activity and oxidative burst, associated to increased immune-suppression that could be reverted by arginase inhibitors in co-culture with lymphocytes. In 43 consecutive newly-diagnosed MM patients, who received first-line treatment based on bortezomib, thalidomide and dexamethasone, high CD64 could identify at diagnosis patients with inferior median overall survival (39.5 versus 86.7 months, p = 0.04). Thus, HDNs are significantly different among healthy, MGUS and MM subjects. In both MGUS and MM neutrophils may play a role in supporting both the increased susceptibility to infection and the immunological dysfunction that leads to tumor progression.
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Affiliation(s)
- A Romano
- Department of Surgery and Medical Specialties, University of Catania, Catania, Italy
- Division of Hematology, Azienda Ospedaliera Policlinico e Vittorio Emanuele di Catania, Catania, Italy
| | - N L Parrinello
- Division of Hematology, Azienda Ospedaliera Policlinico e Vittorio Emanuele di Catania, Catania, Italy
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", University of Catania, Catania, Italy
| | - V Simeon
- Laboratory of Pre-Clinical Research and Advanced Diagnostics, IRCCS-CROB, Rionero in Vulture (Pz), Potenza, Italy
- Department of Mental Health and Preventive Medicine, Medical Statistics Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - F Puglisi
- Division of Hematology, Azienda Ospedaliera Policlinico e Vittorio Emanuele di Catania, Catania, Italy
| | - P La Cava
- Division of Hematology, Azienda Ospedaliera Policlinico e Vittorio Emanuele di Catania, Catania, Italy
| | - C Bellofiore
- Department of Surgery and Medical Specialties, University of Catania, Catania, Italy
- Division of Hematology, Azienda Ospedaliera Policlinico e Vittorio Emanuele di Catania, Catania, Italy
| | - C Giallongo
- Division of Hematology, Azienda Ospedaliera Policlinico e Vittorio Emanuele di Catania, Catania, Italy
| | - G Camiolo
- Division of Hematology, Azienda Ospedaliera Policlinico e Vittorio Emanuele di Catania, Catania, Italy
| | - F D'Auria
- Laboratory of Pre-Clinical Research and Advanced Diagnostics, IRCCS-CROB, Rionero in Vulture (Pz), Potenza, Italy
| | - V Grieco
- Laboratory of Pre-Clinical Research and Advanced Diagnostics, IRCCS-CROB, Rionero in Vulture (Pz), Potenza, Italy
| | - F Larocca
- Laboratory of Pre-Clinical Research and Advanced Diagnostics, IRCCS-CROB, Rionero in Vulture (Pz), Potenza, Italy
| | - A Barbato
- Division of Hematology, Azienda Ospedaliera Policlinico e Vittorio Emanuele di Catania, Catania, Italy
| | - D Cambria
- Division of Hematology, Azienda Ospedaliera Policlinico e Vittorio Emanuele di Catania, Catania, Italy
| | - E La Spina
- Biometec, Dipartimento di Scienze Biomediche e Biotecnologiche, University of Catania, Catania, Italy
| | - D Tibullo
- Biometec, Dipartimento di Scienze Biomediche e Biotecnologiche, University of Catania, Catania, Italy
| | - G A Palumbo
- Division of Hematology, Azienda Ospedaliera Policlinico e Vittorio Emanuele di Catania, Catania, Italy
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", University of Catania, Catania, Italy
| | - C Conticello
- Division of Hematology, Azienda Ospedaliera Policlinico e Vittorio Emanuele di Catania, Catania, Italy
| | - P Musto
- Laboratory of Pre-Clinical Research and Advanced Diagnostics, IRCCS-CROB, Rionero in Vulture (Pz), Potenza, Italy
- Chair and Unit of Hematology and Stem Cell Transplantation, Aldo Moro University, Bari, Italy
| | - F Di Raimondo
- Department of Surgery and Medical Specialties, University of Catania, Catania, Italy.
- Division of Hematology, Azienda Ospedaliera Policlinico e Vittorio Emanuele di Catania, Catania, Italy.
- Department of Mental Health and Preventive Medicine, Medical Statistics Unit, University of Campania "Luigi Vanvitelli", Naples, Italy.
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Zhou X, Sun X, Zhao W, Fang X, Wang X. Prognostic significance of peripheral blood absolute lymphocyte count and derived neutrophil to lymphocyte ratio in patients with newly diagnosed extranodal natural killer/T-cell lymphoma. Cancer Manag Res 2019; 11:4243-4254. [PMID: 31190991 PMCID: PMC6511611 DOI: 10.2147/cmar.s193397] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 02/14/2019] [Indexed: 12/26/2022] Open
Abstract
Background: Accumulating evidence suggested that tumor microenvironment and host immune system played important roles in determining the clinical course and outcome of human malignancies. The derived neutrophil to lymphocyte ratio (dNLR) and absolute lymphocyte count (ALC) were demonstrated to act as a prognostic factor in several malignancies. Nevertheless, the prognostic significance of them in extranodal natural killer/T-cell lymphoma (ENKTL) patients has never been explored. Patients and methods: A total of 33 newly diagnosed patients with ENKTL were included in this study. Clinicopathological characteristics were collected and prognostic significance of dNLR and ALC were evaluated. Results: Elevated dNLR and low ALC were both associated with poor survival rates. Patients with dNLR ≥3.6 revealed significantly shorter overall survival (OS) (P=0.001) and progression-free survival (PFS) (P=0.008) than those with dNLR <3.6. Patients with ALC <0.8×109/L had worse OS (P=0.008) and PFS (P<0.001) than those with ALC ≥0.8×109/L. An independent significant association between low ALC and poor clinical outcome in multivariate analysis for OS (HR, 36.023; 95% CI, 2.438–532.243; P=0.009) as well as PFS (HR, 7.698; 95%CI, 1.573–37.679; P=0.012) was identified. Conclusion: In this study, we validated for the first time the prognostic value of dNLR and ALC in ENKTL patients. Elevated dNLR and low ALC were both associated with aggressive tumor process and poor survival.ALC value at diagnosis represented an independent favorable prognostic factor for the clinical outcome of ENKTL patients.
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Affiliation(s)
- Xiangxiang Zhou
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, People's Republic of China
| | - Xiaogang Sun
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, People's Republic of China
| | - Wenbo Zhao
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, People's Republic of China
| | - Xiaosheng Fang
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, People's Republic of China
| | - Xin Wang
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, People's Republic of China.,Department of Diagnostics, School of Medicine, Shandong University, Jinan, People's Republic of China
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