Does the neutrophil-to-lymphocyte ratio affect survival in multiple myeloma? a single-center experience

Objective: Multiple myeloma (MM) constitutes approximately 1-2% of all cancers and about 17% of hematological malignancies, making it the second most common hematological malignancy. The neutrophil-to-lymphocyte ratio (NLR) is an inflammatory marker that has been shown to be associated with prognosis in solid tumors and lymphomas. In this study, we aimed to investigate the relationship between NLR values at diagnosis and survival, as well as other prognostic factors in patients with MM. Materials and Methods: This study included 196 patients diagnosed with MM at the Department of Hematology, Pamukkale University Faculty of Medicine Hospital, between January 2011 and December 2023. Clinical and laboratory data of the patients were retrospectively recorded from patient files and the hospital information system. The relationship among patients' demographic characteristics, laboratory parameters, clinical status, and the presence of renal dysfunction with survival and NLR was analyzed. Results: In our study, the cut-off value for NLR was determined as 1.8. There was a statistically significant relationship between OS and stage-3 disease, the presence of renal dysfunction, and age over 65. (p=0.001, p=0.001, p<0.001) Similarly, a statistically significant association was found between NLR and the presence of renal dysfunction and age >65 years (p=0.012, p=0.035). Although survival decreased with increasing disease stage, no statistically significant relationship was found between OS and NLR values (p=0.064). Conclusion: The absence of a significant association between OS and NLR in our study may be related to factors such as oxidative stress, infection, and inflammation. However, the presence of common parameters affecting both NLR and OS, such as age, disease stage, and renal dysfunction, suggests that NLR may serve as a useful marker in assessing survival and prognosis.