Therefore, we need to explore some convenient and easily available prognostic indicators. However, MM patients with the same ISS stage also have different prognosis, and fluorescence in situ hybridization (FISH) is very expensive to evaluate the prognosis of MM patients. Other high-risk chromosomal abnormalities in MM are characterized by structural changes, and several studies have confirmed that patients with t (4 14) and t (14 16) have a poor prognosis ( 15– 17).
In addition, the deletion of 17p13 (the locus for the tumor-suppressor gene, p53) leads to the loss of heterozygosity of TP53, which is considered to be a high-risk feature in MM ( 13, 14). The International Staging System (ISS) divides the risk into three grades based on the concentrations of β2-microglobulin and serum albumin which is related to the prognosis of patients with MM ( 12). However, almost all MM patients will relapse eventually, so we urgently need to find valuable prognostic indicators to assess the risk of patients and guide more active treatment, so as to delay the progress of the disease. With the continuous improvement of treatment level (including autologous hematopoietic stem cell transplantation and the emergence of new drugs), the life expectancy of MM patients is gradually prolonging ( 10, 11). More recently, drugs such as carfilzomib, pomalidomide and daratumumab have been approved for the treatment of relapsed multiple myeloma, further improving the efficacy ( 8, 9). In the past 15 years, overall survival (OS) of multiple myeloma has improved significantly with the emergence of thalidomide, bortezomib and lenalidomide ( 4– 7). Unlike other malignant tumors that metastasize to bone, there is no new bone formation in osteolytic bone lesions of multiple myeloma ( 3). It is characterized by a monoclonal proliferation of plasma cells and is associated with insufficient production of complete or incomplete immunoglobulins ( 1, 2). Multiple myeloma accounts for 1% of all cancers and about 10% of all hematological malignant tumors. 13 studies evaluated that elevated NLR was significantly associated with poor survival outcomes (OS: HR=2.04, P0.05 PFS: HR=0.87, P>0.05).Ĭonclusions: 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. Results: Nineteen studies incorporating 3818 MM patients were eventually included in this meta-analysis. All relevant parameters were extracted and combined for statistical analysis.
Methods: Relevant literatures were retrieved from PubMed, Embase and Web of Science databases according to PRISMA guideline. Our study is to evaluate its effectiveness in MM by meta-analysis. Whole blood cell count (WBCC) derived indexes are widely used as a predictive biomarker for various types of solid and hematological malignant tumors. 3Department of Orthopedics, Affiliated Hospital of Southwest Medical University, Luzhou, Chinaīackground: Multiple myeloma (MM) is an incurable malignant plasma cell tumor.2Department of Hematology, Affiliated Hospital of Southwest Medical University, Luzhou, China.1Stem Cell Laboratory, Affiliated Hospital of Southwest Medical University, Luzhou, China.Xinwen Zhang 1,2†, Jialin Duan 1,2†, Zhenyu Wen 3†, Hao Xiong 1,2, Xiaomin Chen 1,2, Yang Liu 1,2, Kunyu Liao 1,2 and Chunlan Huang 1,2*
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