The role of systemi̇c immune-inflammati̇on index and systemi̇c inflammatory response indi̇ces i̇n prognosti̇c evaluati̇on of newly di̇agnosed multi̇ple myeloma pati̇ents

Objective: Multiple Myeloma (MM) is a treatment-resistant and biologically heterogeneous plasma cell disorder (1). In our study, we aimed to evaluate the levels of SII and SIRI in newly diagnosed MM patients and investigate the role of these parameters in prognosis determination. We also assessed the relationship of these indices with disease stage, degree of organ involvement, and laboratory findings. Furthermore, we aimed to demonstrate the clinical applicability of inflammation-based biomarkers in the management of MM and their potential contributions to existing staging systems. Thus, the study seeks to provide important data to support the development of more individualized treatment approaches and to improve patients' quality of life. Materials and Methods: In this retrospective study, 69 MM patients diagnosed between 2015 and 2023 at Afyonkarahisar Health Sciences University were analyzed. Blood tests at diagnosis included hemogram, β2-microglobulin, CRP, LDH, creatinine, calcium, immunoglobulins, and MRI-PET-CT. The prognostic value of systemic immune-inflammation index (SII) and systemic inflammatory response index (SIRI) was evaluated Calculations: SII=(Neutrophils×Platelets)/Lymphocytes SIRI = (Neutrophils × Monocytes) / Lymphocytes Results: In our study, 69 MM patients were evaluated (41 males, 28 females). The average age was 68.3 years, and the follow-up duration was 36.2 months. During the follow-up period, 44.9% of the patients died. The mean overall survival was 58.05 ± 5.02 months, and the estimated median survival time was 53.3 months. A significant difference was found between survival and levels of hemoglobin, NLR, platelet count, creatinine, CRP, LDH, ISS stage, and β2-microglobulin (p < 0.05). Groups with SII < 291.78 and SIRI < 0.7868 showed longer survival. In univariate Cox regression analysis, high levels of CRP, LDH, creatinine, SII, SIRI, and low hemoglobin levels were found to negatively affect survival. Conclusion: In conclusion,SII and SIRI may serve as important tools for evaluating clinical and biological processes and as prognostic indicators in multiple myeloma. In our study, the cut-off value for SII was determined to be 291.78, and for SIRI, 0.7868. Notably, patients with higher SII and SIRI values exhibited shorter overall survival, and this finding was statistically significant. Keywords: Multiple Myeloma, Overall Survival, Prognosis, SII, SIRI