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©The Author(s) 2022.
World J Clin Cases. May 16, 2022; 10(14): 4380-4394
Published online May 16, 2022. doi: 10.12998/wjcc.v10.i14.4380
Published online May 16, 2022. doi: 10.12998/wjcc.v10.i14.4380
Table 1 General information of the 82 multiple myeloma bone disease patients who underwent surgical treatments
Characteristic | Value n (%) or n [SD] |
Age (yr) | 60.33 [9.620] |
Gender | |
Male | 44 (53.7) |
Female | 38 (46.3) |
ISS stage | |
ISS-I | 15 (18.3) |
ISS-II | 37 (45.1) |
ISS-III | 30 (36.6) |
Number of lesions | |
1 | 53 (64.6) |
2 | 18 (22.0) |
≥ 3 | 11 (13.4) |
Site of lesion | |
Spine | 56 (68.3) |
Long bone of limb | 19 (23.2) |
Soft tissue | 7 (8.5) |
Isotype | |
IgA | 23 (28) |
IgD | 3 (3.7) |
IgG | 45 (54.9) |
Light chain κ/λ | 11 (13.4) |
Preoperative chemotherapy | |
Yes | 48 (58.5) |
No | 34 (41.5) |
Postoperative chemotherapy | |
Yes | 71 (86.6) |
No | 11 (13.4) |
Preoperative radiotherapy | |
Yes | 6 (7.3) |
No | 76 (92.7) |
Time from a diagnosis to surgery (mo) | 19.48 [26.69] |
Operation scheme | |
Complete excision1 | 9 (11) |
Partial excision/intramedullary curettage2 | 72 (87.8) |
Tissue biopsy3 | 1 (1.2) |
Autologous stem cell transplantation | |
Yes | 20 (24.4) |
No | 62 (75.6) |
POS (mo) | 27.03 [21.31] |
Total survival (mo) | 46.63 [31.04] |
Table 2 General physical condition of 82 multiple myeloma bone disease patients before surgical treatments
Characteristic | Value n (%) or n [SD] |
Preoperative nutrition | |
Well | 68 (82.9) |
Fairly | 6 (7.3) |
Poorly | 8 (9.8) |
Preoperative BMI (kg/m2) | 23.14 [3.36] |
Preoperative performance status | |
Grade 0-2 | 16 (19.5) |
Grade 3-4 | 66 (80.5) |
Preoperative MM activity | |
Partial remission | 2 (2.4) |
Stable disease | 8 (9.8) |
Progression disease | 72 (87.8) |
Table 3 Comparison of 1-year, 3-year and 5-year cumulative survival rates between the high and the low neutrophil-lymphocyte ratio group
Cutoff value of NLR | 1-yr CSRa | 3-yr CSRa | 5-yr CSRa | Chi-square | P value |
NLR ≥ 4 | 41.7% vs 82.5% | 10.4% vs 60.9% | 0.0% vs 41.7% | 15.969 | 0.000a |
NLR ≥ 3 (n = 26) | 52.0% vs 87.3% | 19.1% vs 67.2% | 0.0% vs 48.3% | 22.192 | 0.000a |
NLR ≥ 2 | 65.8% vs 88.9% | 46.5% vs 61.1% | 31.0% vs 34.0% | 2.015 | 0.156 |
NLR ≥ 1 | 75.3% vs 85.7% | 52.6% vs - | 30.6% vs - | 0.459 | 0.498 |
Table 4 Univariate analysis of the general information of patients in the high and the low neutrophil-lymphocyte ratio group
Characteristic | NLR < 3 (n = 56) | NLR ≥ 3 (n = 26) | P value |
Age (yr) | 60.93 ± 9.88 | 59.04 ± 9.10 | 0.411 |
Gender, n (%) | 0.981 | ||
Male | 30 (53.6) | 14 (53.8) | |
Female | 26 (46.4) | 12 (46.2) | |
ISS stage, n (%) | 0.693 | ||
ISS-I | 10 (17.9) | 5 (19.2) | |
ISS-II | 27 (48.2) | 10 (38.5) | |
ISS-III | 19 (33.9) | 11 (42.3) | |
Number of lesions, n (%) | 0.033a | ||
1 | 41 (73.2) | 12 (46.2) | |
2 | 8 (14.3) | 10 (38.5) | |
≥ 3 | 7 (12.5) | 4 (15.4) | |
Site of lesion, n (%) | 0.982 | ||
Spine | 38 (67.9) | 18 (69.2) | |
Long bone of limb | 13 (23.2) | 6 (23.1) | |
Soft tissue | 5 (8.9) | 2 (7.7) | |
Time from a diagnosis to surgery (mo) | 21.18 ± 29.75 | 15.81 ± 18.44 | 0.321 |
Preoperative nutrition, n (%) | 0.071 | ||
Well | 50 (89.3) | 18 (69.2) | |
Fairly | 3 (5.4) | 3 (11.5) | |
Poorly | 3 (5.4) | 5 (19.2) | |
Preoperative BMI (kg/m2) | 23.80 ± 3.29 | 21.74 ± 3.13 | 0.009a |
Preoperative performance status, n (%) | 0.066 | ||
Grade 0-2 | 14 (25.0) | 2 (7.7) | |
Grade 3-4 | 42 (75.0) | 24 (92.3) | |
MM activity at the time of surgery, n (%) | 0.590 | ||
Partial response | 2 (3.6) | 0 (0.0) | |
Stable disease | 5 (8.9) | 3 (11.5) | |
Progressive disease | 49 (87.5) | 23 (88.5) | |
Preoperative chemotherapy, n (%) | 0.707 | ||
Yes | 32 (57.1) | 16 (61.5) | |
No | 24 (42.9) | 10 (38.5) | |
Preoperative chemotherapy regimens (n = 48), n (%) | 0.216 | ||
Immunomodulator-based | 6 (37.5) | 5 (15.6) | |
Proteasome inhibitor-based | 6 (37.5) | 14 (43.8) | |
Both immunomodulator and proteasome inhibitor | 4 (25.0) | 13 (40.6) | |
Postoperative chemotherapy, n (%) | 0.080 | ||
Yes | 51 (91.1) | 20 (76.9) | |
No | 5 (8.9) | 6 (23.1) | |
Postoperative chemotherapy regimens (n = 71), n (%) | 0.159 | ||
Immunomodulator-based | 3 (6.0) | 4 (19.0) | |
Proteasome inhibitor-based | 17 (34.0) | 4 (19.0) | |
Both immunomodulator and proteasome inhibitor | 30 (60.0) | 13 (61.9) | |
Autologous stem cell transplantation, n (%) | 0.458 | ||
Yes | 15 (26.8) | 5 (19.2) | |
No | 41 (73.2) | 21 (80.8) | |
POS (mo) | 32.68 ± 21.76 | 14.86 ± 14.28 | 0.001 |
Table 5 Univariate analysis of the preoperative laboratory examination of patients in the high and the low neutrophil-lymphocyte ratio group
Preoperative laboratory examination | NLR < 3 (n = 56) | NLR ≥ 3 (n = 26) | P value |
Hb (g/L) | 112.66 ± 24.88 | 100.58 ± 25.91 | 0.047a |
PLT (109/L)a | 208.38 ± 77.39 | 196.89 ± 103.64 | 0.577 |
ALb (g/L) | 32.88 ± 6.02 | 31.16 ± 6.29 | 0.237 |
AST (U/L) | 22.89 ± 8.39 | 33.96 ± 18.79 | 0.007a |
ALT (U/L) | 19.89 ± 10.28 | 28.46 ± 24.17 | 0.093 |
Γ-GT (U/L) | 34.11 ± 27.52 | 47.58 ± 38.19 | 0.073 |
Blood β2-MG (mg/L) | 5.43 ± 9.08 | 4.10 ± 2.85 | 0.475 |
Cr (umol/L) | 84.54 ± 73.73 | 89.38 ± 85.84 | 0.794 |
Preoperative CRP (mg/L) | 2.60 ± 3.84 | 3.67 ± 3.93 | 0.411 |
Post-operative CRP (mg/L) | 1.98 ± 2.79 | 1.83 ± 2.06 | 0.877 |
Table 6 One-way ANOVA results of peripheral blood absolute lymphocyte counts, absolute neutrophil counts and neutrophil-lymphocyte ratio of the 82 multiple myeloma bone disease patients at different time points (mean ± SD)
Characteristic | Before operation | 1 wk after operation | 1 mo after operation | Last follow-up visit | F | P value |
Absolute blood lymphocyte counts | 1.34 ± 0.75 | 1.19 ± 0.55 | 1.45 ± 0.76 | 1.15 ± 0.821,2 | 2.382 | 0.070 |
Absolute neutrophil counts | 3.87 ± 2.07 | 4.79 ± 2.373-5 | 3.72 ± 1.96 | 3.36 ± 2.04 | 4.376 | 0.005 |
NLR | 2.78 ± 1.976,7 | 4.56 ± 2.33 | 3.14 ± 2.198 | 5.03 ± 6.73 | 4.998 | 0.002 |
Lymphocyte percentages (%) | 25.09 ± 9.96 | 18.19 ± 7.193,4 | 26.66 ± 10.70 | 22.83 ± 12.68 | 5.770 | 0.001 |
Table 7 Kaplan–Meier analysis of postoperative survival of patients with multiple myeloma bone disease (univariate survival analysis)
Characteristic | Chi-square | P value |
Gender | 1.703 | 0.192 |
ISS stage | 1.966 | 0.374 |
Number of lesions | 7.055 | 0.029a |
Site of lesion | 8.160 | 0.017a |
Isotype | 1.526 | 0.676 |
Preoperative chemotherapy | 0.387 | 0.534 |
Postoperative chemotherapy | 35.837 | 0.000a |
Preoperative radiotherapy | 0.908 | 0.341 |
Time from a diagnosis to surgery | 1.841 | 0.606 |
Operation scheme | 3.583 | 0.167 |
Stem cell transplantation | 2.836 | 0.092 |
Preoperative peripheral blood NLR ≥ 3 | 22.192 | 0.000a |
Preoperative nutrition | 0.782 | 0.676 |
Preoperative performance status | 20.775 | 0.000a |
Preoperative MM activity | 1.634 | 0.652 |
Table 8 Multivariate Cox regression analysis of postoperative survival of patients with multiple myeloma bone disease
- Citation: 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(14): 4380-4394
- URL: https://www.wjgnet.com/2307-8960/full/v10/i14/4380.htm
- DOI: https://dx.doi.org/10.12998/wjcc.v10.i14.4380