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. 2018 Jan 23:11:499-507.
doi: 10.2147/OTT.S153146. eCollection 2018.

Prognostic role of neutrophil-lymphocyte ratio in multiple myeloma: a dose-response meta-analysis

Shidai Mu #  1 , Lisha Ai #  1 , Fengjuan Fan  1 , Chunyan Sun  1 , Yu Hu  1
Affiliations

Prognostic role of neutrophil-lymphocyte ratio in multiple myeloma: a dose-response meta-analysis

Shidai Mu et al. Onco Targets Ther. .

Abstract

Background: The neutrophil-lymphocyte ratio (NLR), a biomarker for systematic inflammation, has been recently identified as a prognostic factor for various types of both solid and hematologic malignancies. Our study presented here was the first meta-analysis assessing the prognostic role of NLR in multiple myeloma (MM).

Methods: We systematically searched PubMed, Embase, and ISI Web of Science for relevant studies. Odds ratios (ORs) or hazards ratios (HRs) with corresponding 95% CIs are pooled to estimate the association between NLR and clinicopathological parameters or survival of MM patients.

Results: Seven trials with 1,971 MM patients were enrolled in the meta-analysis, and the results indicated that elevated pretreatment NLR was significantly associated with advanced tumor stages (International Staging System [ISS] III vs ISS I-II: OR 2.427, 95% CI: 1.268-4.467; and Durie-Salmon III vs Durie-Salmon I-II: OR 1.738, 95% CI: 1.133-2.665). Moreover, increased NLR also predicted poorer overall survival (HR 2.084, 95% CI: 1.341-3.238) and progression-free survival (HR 1.029, 95% CI: 1.016-1.042). And two-stage dose-response meta-analysis revealed linear association between increased NLR and risk of mortality in MM patients.

Conclusion: We can conclude that MM patients with higher NLR are more likely to have poorer prognosis than those with lower NLR.

Keywords: dose–response meta-analysis; multiple myeloma; neutrophil–lymphocyte ratio; prognosis.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flow diagram of the selection of relevant published works regarding NLR in MM. Abbreviations: MM, multiple myeloma; NLR, neutrophil–lymphocyte ratio.
Figure 2
Figure 2
Forest plots showing the association between elevated NLR and clinicopathological parameters. (A) ISS staging (III vs I–II); (B) D-S staging (III vs I–II). Abbreviations: OR, odds ratio; NLR, neutrophil–lymphocyte ratio; ISS, International Staging System.
Figure 3
Figure 3
(A) Meta-analysis of the association between elevated NLR and OS of MM. (B) Dose-response analysis of the prognostic role of NLR in OS of MM. Abbreviations: HR, hazards ratio; NLR, neutrophil–lymphocyte ratio; MM, multiple myeloma; OS, overall survival.
Figure 4
Figure 4
(A) Meta-analysis of the association between elevated NLR and PFS of MM. (B) Dose-response analysis of the prognostic role of NLR in PFS of MM. Abbreviations: HR, hazards ratio; NLR, neutrophil–lymphocyte ratio; MM, multiple myeloma; PFS, progression-free survival.
Figure 5
Figure 5
Sensitivity analysis of the overall pooled study for OS. Abbreviation: OS, overall survival.
Figure 6
Figure 6
Publication bias of the present meta-analysis. Abbreviation: HR, hazards ratio.
See this image and copyright information in PMC

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