初诊多发性骨髓瘤患者外周血淋巴细胞绝对值/ 单核细胞绝对值比值在预测临床预后的价值研究

目的 探讨淋巴细胞绝对计数(absolute lymphocyte count,ALC)和单核细胞绝对计数(absolute monocyte count,AMC)比值(ALC/AMC)在预测初诊多发性骨髓瘤(multiple myeloma,MM)患者临床预后中的价值。方法 选取372例初发MM患者为研究对象,收集患者入院时的一般资料,比较患者五年总生存期(overall survival,OS)和无进展生存期(progression-free survival,PFS)率及分析其危险因素。结果 ALC/AMC的阈值为3.6,ALC/AMC≥3.6和ALC/AMC<3.6患者的年龄、β₂微球蛋白、血红蛋白、髓外疾病、ISS分期、del(17p),t(4; 14)和二倍体差异均有统计学意义(t=3.247,6.097,8.236,χ²=9.147,10.618,5.913,5.239,6.190,均P<0.05)。ALC/AMC≥3.6和ALC/AMC<3.6患者五年OS和PFS率之间差异有统计学意义,且ALC/AMC≥3.6的患者高于ALC/AMC<3.6患者(P<0.001)。ALC/AMC<3.6是预测MM患者五年OS和PFS率降低的独立危险因素。结论 外周血ALC/AMC的降低能有效预测初发MM患者的总体生存率和无进展生存率。

Value of Peripheral Blood Lymphocyte Absolute Value/Monocyte Absolute Value Ratio in Predicting Clinical Prognosis of Newly Diagnosed Multiple Myeloma Patients

Objective To investigate the value of absolute lymphocyte count(ALC)and absolute monocyte count(AMC)ratio(ALC/AMC)in patients with newly diagnosed multiple myeloma(MM). Methods A total of 372 patients with newly diagnosed MM were selected as research objects, and the general data of patients upon admission were collected to compare the five-year OS and PFS rates of patients and analyzed their risk factors.Results The threshold value of ALC/AMC was 3.6. There existed significant differences in age, beta 2 microglobulin, hemoglobin, extramedullary diseases, ISS stages, del(17p), t(4; 14)and diploid among ALC/AMC≥3.6 and ALC/AMC<3.6 patients(t=3.247,6.097,8.236,χ²=9.147,10.618,5.913,5.239,6.190,all P<0.05). There were statistically significant differences between ALC/AMC≥3.6 and ALC/AMC<3.6 overall survival(OS)and progress free survival(PFS)rates and ALC/AMC≥3.6 patients were higher than ALC/AMC<3.6(P<0.001). ALC/AMC<3.6 was an independent risk factor for predicting 5-year decrease in OS and PFS rates in MM patients. Conclusion The reduction of peripheral blood ALC to AMC ratio can effectively predict the OS and PFS rates of patients with newly diagnosed MM.