The derived neutrophil-to-lymphocyte ratio is an independent prognostic factor in transplantation ineligible patients with multiple myeloma

Gyeong Won Lee, Sung Woo Park, Se Il Go, Hoon Gu Kim, Min Kyoung Kim, Chang Ki Min, Jae Yong Kwak, Sang Byung Bae, Sung Soo Yoon, Je Jung Lee, Ki Hwan Kim, Seung Hyun Nam, Yeung Chul Mun, Hyo Jung Kim, Sung Hwa Bae, Ho Jin Shin, Jung Hee Lee, Joon Seong Park, Seong Hyun Jeong, Mark Hong LeeHo Sup Lee, Keon Woo Park, Won Sik Lee, Sang Min Lee, Jeong Ok Lee, Myung Soo Hyun, Deog Yeon Jo, Sung Nam Lim, Jae Hoon Lee, Hawk Kim, Do Yeun Cho, Young Rok Do, Jeong A. Kim, Seong Kyu Park, Jin Seok Kim, Soo Jeong Kim, Hyeon Gyu Yi, Joon Ho Moon, Chul Won Choi, Sung Hyun Kim, Byung Soo Kim, Moo Rim Park, Hyeok Shim, Moo Kon Song, Youngdoe Kim, Kihyun Kim

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: The neutrophil-to-lymphocyte ratio (NLR) is an independent prognostic marker in solid and hematological cancers. While the derived NLR (dNLR) was shown to be non-inferior to the NLR in large cohorts of patients with different cancer types, it has not been validated as a prognostic marker for multiple myeloma (MM) to date. Methods: Between May 22, 2011 and May 29, 2014, 176 patients with MM from 38 centers who were ineligible for autologous stem cell transplantation were analyzed. The dNLR was calculated using complete blood count differential data. The optimal dNLR cut-off value according to receiver operating characteristic analysis of overall survival (OS) was 1.51. All patients were treated with melphalan and prednisone combined with bortezomib. Results: The complete response rate was lower in the high dNLR group compared to the low dNLR group (7 vs. 26.1%, respectively; p = 0.0148); the corresponding 2-year OS rates were 72.2 and 84.7%, respectively (p = 0.0354). A high dNLR was an independent poor prognostic factor for OS (hazard ratio 2.217, 95% CI 1.015-4.842; p = 0.0458). Conclusion: The dNLR is a readily available and cheaply obtained parameter in clinical studies, and shows considerable potential as a new prognostic marker for transplantation-ineligible patients with MM.

Original languageEnglish
Pages (from-to)146-156
Number of pages11
JournalActa Haematologica
Volume140
Issue number3
DOIs
Publication statusPublished - 2018 Oct 1

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Multiple Myeloma
Neutrophils
Transplantation
Lymphocytes
Melphalan
Blood Cell Count
Stem Cell Transplantation
Survival Analysis
Prednisone
ROC Curve
Neoplasms
Survival Rate
Survival

All Science Journal Classification (ASJC) codes

  • Hematology

Cite this

Lee, Gyeong Won ; Park, Sung Woo ; Go, Se Il ; Kim, Hoon Gu ; Kim, Min Kyoung ; Min, Chang Ki ; Kwak, Jae Yong ; Bae, Sang Byung ; Yoon, Sung Soo ; Lee, Je Jung ; Kim, Ki Hwan ; Nam, Seung Hyun ; Mun, Yeung Chul ; Kim, Hyo Jung ; Bae, Sung Hwa ; Shin, Ho Jin ; Lee, Jung Hee ; Park, Joon Seong ; Jeong, Seong Hyun ; Lee, Mark Hong ; Lee, Ho Sup ; Park, Keon Woo ; Lee, Won Sik ; Lee, Sang Min ; Lee, Jeong Ok ; Hyun, Myung Soo ; Jo, Deog Yeon ; Lim, Sung Nam ; Lee, Jae Hoon ; Kim, Hawk ; Cho, Do Yeun ; Do, Young Rok ; Kim, Jeong A. ; Park, Seong Kyu ; Kim, Jin Seok ; Kim, Soo Jeong ; Yi, Hyeon Gyu ; Moon, Joon Ho ; Choi, Chul Won ; Kim, Sung Hyun ; Kim, Byung Soo ; Park, Moo Rim ; Shim, Hyeok ; Song, Moo Kon ; Kim, Youngdoe ; Kim, Kihyun. / The derived neutrophil-to-lymphocyte ratio is an independent prognostic factor in transplantation ineligible patients with multiple myeloma. In: Acta Haematologica. 2018 ; Vol. 140, No. 3. pp. 146-156.
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title = "The derived neutrophil-to-lymphocyte ratio is an independent prognostic factor in transplantation ineligible patients with multiple myeloma",
abstract = "Background: The neutrophil-to-lymphocyte ratio (NLR) is an independent prognostic marker in solid and hematological cancers. While the derived NLR (dNLR) was shown to be non-inferior to the NLR in large cohorts of patients with different cancer types, it has not been validated as a prognostic marker for multiple myeloma (MM) to date. Methods: Between May 22, 2011 and May 29, 2014, 176 patients with MM from 38 centers who were ineligible for autologous stem cell transplantation were analyzed. The dNLR was calculated using complete blood count differential data. The optimal dNLR cut-off value according to receiver operating characteristic analysis of overall survival (OS) was 1.51. All patients were treated with melphalan and prednisone combined with bortezomib. Results: The complete response rate was lower in the high dNLR group compared to the low dNLR group (7 vs. 26.1{\%}, respectively; p = 0.0148); the corresponding 2-year OS rates were 72.2 and 84.7{\%}, respectively (p = 0.0354). A high dNLR was an independent poor prognostic factor for OS (hazard ratio 2.217, 95{\%} CI 1.015-4.842; p = 0.0458). Conclusion: The dNLR is a readily available and cheaply obtained parameter in clinical studies, and shows considerable potential as a new prognostic marker for transplantation-ineligible patients with MM.",
author = "Lee, {Gyeong Won} and Park, {Sung Woo} and Go, {Se Il} and Kim, {Hoon Gu} and Kim, {Min Kyoung} and Min, {Chang Ki} and Kwak, {Jae Yong} and Bae, {Sang Byung} and Yoon, {Sung Soo} and Lee, {Je Jung} and Kim, {Ki Hwan} and Nam, {Seung Hyun} and Mun, {Yeung Chul} and Kim, {Hyo Jung} and Bae, {Sung Hwa} and Shin, {Ho Jin} and Lee, {Jung Hee} and Park, {Joon Seong} and Jeong, {Seong Hyun} and Lee, {Mark Hong} and Lee, {Ho Sup} and Park, {Keon Woo} and Lee, {Won Sik} and Lee, {Sang Min} and Lee, {Jeong Ok} and Hyun, {Myung Soo} and Jo, {Deog Yeon} and Lim, {Sung Nam} and Lee, {Jae Hoon} and Hawk Kim and Cho, {Do Yeun} and Do, {Young Rok} and Kim, {Jeong A.} and Park, {Seong Kyu} and Kim, {Jin Seok} and Kim, {Soo Jeong} and Yi, {Hyeon Gyu} and Moon, {Joon Ho} and Choi, {Chul Won} and Kim, {Sung Hyun} and Kim, {Byung Soo} and Park, {Moo Rim} and Hyeok Shim and Song, {Moo Kon} and Youngdoe Kim and Kihyun Kim",
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Lee, GW, Park, SW, Go, SI, Kim, HG, Kim, MK, Min, CK, Kwak, JY, Bae, SB, Yoon, SS, Lee, JJ, Kim, KH, Nam, SH, Mun, YC, Kim, HJ, Bae, SH, Shin, HJ, Lee, JH, Park, JS, Jeong, SH, Lee, MH, Lee, HS, Park, KW, Lee, WS, Lee, SM, Lee, JO, Hyun, MS, Jo, DY, Lim, SN, Lee, JH, Kim, H, Cho, DY, Do, YR, Kim, JA, Park, SK, Kim, JS, Kim, SJ, Yi, HG, Moon, JH, Choi, CW, Kim, SH, Kim, BS, Park, MR, Shim, H, Song, MK, Kim, Y & Kim, K 2018, 'The derived neutrophil-to-lymphocyte ratio is an independent prognostic factor in transplantation ineligible patients with multiple myeloma', Acta Haematologica, vol. 140, no. 3, pp. 146-156. https://doi.org/10.1159/000490488

The derived neutrophil-to-lymphocyte ratio is an independent prognostic factor in transplantation ineligible patients with multiple myeloma. / Lee, Gyeong Won; Park, Sung Woo; Go, Se Il; Kim, Hoon Gu; Kim, Min Kyoung; Min, Chang Ki; Kwak, Jae Yong; Bae, Sang Byung; Yoon, Sung Soo; Lee, Je Jung; Kim, Ki Hwan; Nam, Seung Hyun; Mun, Yeung Chul; Kim, Hyo Jung; Bae, Sung Hwa; Shin, Ho Jin; Lee, Jung Hee; Park, Joon Seong; Jeong, Seong Hyun; Lee, Mark Hong; Lee, Ho Sup; Park, Keon Woo; Lee, Won Sik; Lee, Sang Min; Lee, Jeong Ok; Hyun, Myung Soo; Jo, Deog Yeon; Lim, Sung Nam; Lee, Jae Hoon; Kim, Hawk; Cho, Do Yeun; Do, Young Rok; Kim, Jeong A.; Park, Seong Kyu; Kim, Jin Seok; Kim, Soo Jeong; Yi, Hyeon Gyu; Moon, Joon Ho; Choi, Chul Won; Kim, Sung Hyun; Kim, Byung Soo; Park, Moo Rim; Shim, Hyeok; Song, Moo Kon; Kim, Youngdoe; Kim, Kihyun.

In: Acta Haematologica, Vol. 140, No. 3, 01.10.2018, p. 146-156.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The derived neutrophil-to-lymphocyte ratio is an independent prognostic factor in transplantation ineligible patients with multiple myeloma

AU - Lee, Gyeong Won

AU - Park, Sung Woo

AU - Go, Se Il

AU - Kim, Hoon Gu

AU - Kim, Min Kyoung

AU - Min, Chang Ki

AU - Kwak, Jae Yong

AU - Bae, Sang Byung

AU - Yoon, Sung Soo

AU - Lee, Je Jung

AU - Kim, Ki Hwan

AU - Nam, Seung Hyun

AU - Mun, Yeung Chul

AU - Kim, Hyo Jung

AU - Bae, Sung Hwa

AU - Shin, Ho Jin

AU - Lee, Jung Hee

AU - Park, Joon Seong

AU - Jeong, Seong Hyun

AU - Lee, Mark Hong

AU - Lee, Ho Sup

AU - Park, Keon Woo

AU - Lee, Won Sik

AU - Lee, Sang Min

AU - Lee, Jeong Ok

AU - Hyun, Myung Soo

AU - Jo, Deog Yeon

AU - Lim, Sung Nam

AU - Lee, Jae Hoon

AU - Kim, Hawk

AU - Cho, Do Yeun

AU - Do, Young Rok

AU - Kim, Jeong A.

AU - Park, Seong Kyu

AU - Kim, Jin Seok

AU - Kim, Soo Jeong

AU - Yi, Hyeon Gyu

AU - Moon, Joon Ho

AU - Choi, Chul Won

AU - Kim, Sung Hyun

AU - Kim, Byung Soo

AU - Park, Moo Rim

AU - Shim, Hyeok

AU - Song, Moo Kon

AU - Kim, Youngdoe

AU - Kim, Kihyun

PY - 2018/10/1

Y1 - 2018/10/1

N2 - Background: The neutrophil-to-lymphocyte ratio (NLR) is an independent prognostic marker in solid and hematological cancers. While the derived NLR (dNLR) was shown to be non-inferior to the NLR in large cohorts of patients with different cancer types, it has not been validated as a prognostic marker for multiple myeloma (MM) to date. Methods: Between May 22, 2011 and May 29, 2014, 176 patients with MM from 38 centers who were ineligible for autologous stem cell transplantation were analyzed. The dNLR was calculated using complete blood count differential data. The optimal dNLR cut-off value according to receiver operating characteristic analysis of overall survival (OS) was 1.51. All patients were treated with melphalan and prednisone combined with bortezomib. Results: The complete response rate was lower in the high dNLR group compared to the low dNLR group (7 vs. 26.1%, respectively; p = 0.0148); the corresponding 2-year OS rates were 72.2 and 84.7%, respectively (p = 0.0354). A high dNLR was an independent poor prognostic factor for OS (hazard ratio 2.217, 95% CI 1.015-4.842; p = 0.0458). Conclusion: The dNLR is a readily available and cheaply obtained parameter in clinical studies, and shows considerable potential as a new prognostic marker for transplantation-ineligible patients with MM.

AB - Background: The neutrophil-to-lymphocyte ratio (NLR) is an independent prognostic marker in solid and hematological cancers. While the derived NLR (dNLR) was shown to be non-inferior to the NLR in large cohorts of patients with different cancer types, it has not been validated as a prognostic marker for multiple myeloma (MM) to date. Methods: Between May 22, 2011 and May 29, 2014, 176 patients with MM from 38 centers who were ineligible for autologous stem cell transplantation were analyzed. The dNLR was calculated using complete blood count differential data. The optimal dNLR cut-off value according to receiver operating characteristic analysis of overall survival (OS) was 1.51. All patients were treated with melphalan and prednisone combined with bortezomib. Results: The complete response rate was lower in the high dNLR group compared to the low dNLR group (7 vs. 26.1%, respectively; p = 0.0148); the corresponding 2-year OS rates were 72.2 and 84.7%, respectively (p = 0.0354). A high dNLR was an independent poor prognostic factor for OS (hazard ratio 2.217, 95% CI 1.015-4.842; p = 0.0458). Conclusion: The dNLR is a readily available and cheaply obtained parameter in clinical studies, and shows considerable potential as a new prognostic marker for transplantation-ineligible patients with MM.

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U2 - 10.1159/000490488

DO - 10.1159/000490488

M3 - Article

C2 - 30253397

AN - SCOPUS:85054127663

VL - 140

SP - 146

EP - 156

JO - Acta Haematologica

JF - Acta Haematologica

SN - 0001-5792

IS - 3

ER -