| 蒋洁,朱文艳,苏倩倩,李锦,叶龙.NLR、MLR、低蛋白血症对硼替佐米为基础方案化疗的多发性骨髓瘤疗效及预后的影响.[J].中南医学科学杂志.,2024,(6):942-945. |
| NLR、MLR、低蛋白血症对硼替佐米为基础方案化疗的多发性骨髓瘤疗效及预后的影响 |
| The curative effect and prognostic impact of NLR, MLR, and hypoalbuminemia on multiple myeloma treated with bortezomib-based chemotherapy |
| 投稿时间：2023-12-30 修订日期：2024-10-08 |
| DOI：10.15972/j.cnki.43-1509/r.2024.06.016 |
| 中文关键词: 中性粒细胞/淋巴细胞 单核细胞/淋巴细胞 低蛋白血症 多发性骨髓瘤 硼替佐米 疗效 预后 |
| 英文关键词:NLR MLR hypoalbuminemia MM bortezomib curative effect prognosis |
| 基金项目:江南大学附属医院研究型医院医学科研项目(YJY202304)；无锡市卫生健康委科研项目资助青年项目(Q202321) 作者简介:蒋洁,硕士,住院医师,研究方向为血液病的诊治,E-mail为18862931139@163.com。通信作者叶龙,博士,主治医师,研究方向为多发性骨髓瘤的临床与基础,E-mail为yelong@jiangnan.edu.cn。 |
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| 中文摘要: |
| 目的分析中性粒细胞/淋巴细胞(NLR)、单核细胞/淋巴细胞(MLR)、低蛋白血症对硼替佐米为基础方案化疗的多发性骨髓瘤(MM)患者疗效及预后的影响。 方法选取80例实施硼替佐米为基础方案化疗的初诊MM患者,根据其化疗疗效,将其分为有效组52例、无效组28例。比较两组患者化疗前NLR、MLR水平以及低蛋白血症患者占比；采用单因素分析两组患者的基线资料、病理学特征及相关实验室指标,通过多因素Logistic回归分析MM患者化疗效果的影响因素。 结果无效组MLR≥0.14、低蛋白血症患者占比均显著高于有效组(P＜0.05)。两组国际分期系统(international staging system,ISS)、β2微球蛋白水平比较,差异具有统计学意义(P＜0.05)。MLR≥0.14、低蛋白血症、ISS分期Ⅲ期是MM患者采用硼替佐米为基础方案化疗反应性差的危险因素(P＜0.05)。80例患者随访2年生存48例(60%)。MLR＜0.14的MM患者生存时间长于MLR≥0.14的患者(P＜0.05),低蛋白血症的MM患者生存时间短于非低蛋白血症的患者(P＜0.05)。 结论化疗前高水平MLR合并低蛋白血症是多发性骨髓瘤患者采用硼替佐米为基础方案化疗疗效差的危险因素,并可预测患者不良预后,而NLR对其化疗疗效及预后无影响。 |
| 英文摘要: |
| AimTo analyze the curative effect and prognostic impact of neutrophil/lymphocyte (NLR), monocyte/lymphocyte (MLR), and hypoalbuminemia on patients with multiple myeloma (MM) receiving bortezomib-based chemotherapy. MethodsEighty newly diagnosed MM patients who received bortezomib-based chemotherapy were selected and divided into an effective group (52 cases) and an ineffective group (28 cases) according to their chemotherapy efficacy. The levels of NLR, MLR and the proportion of patients with hypoproteinemia before chemotherapy were compared between the two groups. The baseline data, pathological features and relevant laboratory indicators of patients in the two groups were analyzed by single factor method, and the related factors affecting the chemotherapy effect of patients with MM were analyzed by multivariate Logistic regression analysis. ResultsThe proportion of patients with MLR≥0.14 and hypoproteinemia in the ineffective group was significantly higher than those in the effective group (P＜0.05). There were significant differences in international staging system (ISS) stage and β2 microglobulin level between the two groups (P＜0.05). MLR≥0.14, hypoproteinemia and ISS stage Ⅲ were risk factors for poor chemotherapy response to bortezomib in MM patients (P＜0.05). Of the 80 patients, 48 (60%) survived at 2 years. The survival time of patients with MLR＜0.14 was longer than that of MM patients with MLR≥0.14 (P＜0.05), and the survival time of patients with MM with hypoproteinemia was shorter than that of patients without hypoproteinemia (P＜0.05). ConclusionHigh levels of MLR and hypoalbuminemia before chemotherapy are risk factors for poor efficacy of bortezomib-based chemotherapy in patients with MM, which can predict poor prognosis of MM, while NLR has no effect on chemotherapy responsiveness and prognosis. |
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