Prognostic Significance Of The Inflammatory Index-Based Scoring System In Patients Preliminarily Diagnosed With Multiple Myeloma In The Bortezomib-Based Chemotherapy Era

Abstract

Siwei Liu,1 Jie Shi,2 Honggang Guo,2 Fangfang Xu,2 Min Wei,1 Kai Sun,2 Yuqing Chen2 1Department of Hematology, Henan University People’s Hospital, School of Clinical Medicine, Henan University, Zhengzhou 450003, Henan, People’s Republic of China; 2Department of Hematology, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan, People’s Republic of ChinaCorrespondence: Yuqing ChenDepartment of Hematology, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, #7 Weiwu Road, Zhengzhou, Henan 450003, People’s Republic of ChinaTel [phone]Fax [phone]Email [email protected] SunDepartment of Hematology, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, #7 Weiwu Road, Zhengzhou, Henan 450003, People’s Republic of ChinaTel [phone]Email [email protected]: Red blood cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), and platelet count (PLT) have been reported to be associated with the prognosis of malignancies; this study aimed to evaluate the prognostic significance of the inflammatory prognostic scoring index (IPSI), comprised of RDW, N LR, and PLT for overall survival (OS) in newly diagnosed multiple myeloma patients in the bortezomib-based chemotherapy era.Patients and methods: The prognostic significance of variables associated with the OS of 175 newly diagnosed multiple myeloma patients was evaluated through univariate and multivariate analyses. The cut-off values of RDW, NLR, and PLT were obtained from references. Patients with high RDW (RDW>14) were given a score of 1; patients with high NLR (NLR>2) or low PLT (PLT≤150) were given a score of 2. According to the obtained scores, the inflammatory prognostic scoring index (IPSI) was formed, in which patients were grouped into high-risk group (4–5 points), intermediate-risk group (3 points) and low-risk group (0–2 points).Results: OS varied significantly in different IPSI groups (P< 0.001). On multivariate analysis, the IPSI was an independent prognostic factor for OS (intermediate-risk group HR 2.89, 95% CI 1.60–5.22, high risk-group HR 14.50, 95% CI 7.26–28.93, P<0.001). Importantly, with IPSI as supplement to the International Staging System (ISS), a significant difference in OS was observed among IPSI subgroups (ISS I, P<0.001; ISS II, P=0.008; ISS III, P<0.001).Conclusion: The IPSI, comprised of RDW, NLR, and PLT, played specific role in the prognosis of patients preliminarily diagnosed with multiple myeloma in the bortezomib-based chemotherapy era and could be a beneficial supplement for ISS staging.Keywords: multiple myeloma, red blood cell distribution width, neutrophil-to-lymphocyte ratio, platelet count, inflammatory prognostic scoring index

Keywords

• multiple myeloma
• red blood cell distribution width
• neutrophil-to-lymphocyte ratio
• platelet count
• inflammatory prognostic scoring index