多发性骨髓瘤患者外周血淋巴细胞计数单核细胞计数淋巴细胞与单核细胞比值与患者预后的关系

Correlation Analysis of Peripheral Blood Lymphocyte Count Monocyte Count Lymphocyte to Monocyte Ratio and Clinical Data and Prognosis of Patients with Multiple Myeloma

目的:探究多发性骨髓瘤(multiple myeloma,MM)患者外周血淋巴细胞计数(absolute lymphocyte count,ALC)、单核细胞计数(absolute monocyte count,AMC)、淋巴细胞与单核细胞比值(lymphocyte to monocyte ratio,LMR)与预后的相关性。方法:选择2016年3月至2019年8月我院收治的115例初诊MM患者作为研究对象,收集ALC、AMC、LMR等资料,随访统计总生存时间(overall survival,OS)。结果:①115例MM患者外周血ALC为(0.22~13.48)×10^9L^-1,平均(1.77±0.45)×10^9L^-1;外周血AMC为(0.01~0.98)×10^9L^-1,平均(0.45±0.12)×10^9L^-1;LMR为1.18~12.74,平均4.74±0.85。②将外周血ALC、AMC、LMR中位值作为截断值进行分组,高ALC组及低ALC组、高AMC组及低AMC组血红蛋白(hemoglobin,Hb)、乳酸脱氢酶(lactate dehydrogenase,LDH)、β2-微球蛋白(lactate dehydrogenase,β2-MG)等资料比较差异具统计学意义(P<0.05);高LMR组、低LMR组患者Hb、β2-MG比较差异具统计学意义(P<0.05)。③绘制Kaplan-Meier生存曲线,高ALC组、低AMC组、高LMR组患者总体OS显著高于低ALC组、高AMC组、低LMR组(P<0.05)。④Cox多因素分析示,DS分期Ⅲ期、LDH>245U/L、Hb≤110g/L、ALC≤0.65×10^9L^-1、LMR≤3.85是初治MM患者预后不良的独立危险因素(P<0.05)。结论:MM患者ALC、AMC、LMR水平与预后相关,临床可根据结果初步评估及预测患者预后,指导临床治疗。

Objective:To explore the correlations among peripheral blood absolute lymphocyte count(ALC),absolute monocyte count(AMC),lymphocyte to monocyte ratio(LMR)and clinical data and prognosis in patients with multiple myeloma(MM).Methods:A total of 115 patients with newly diagnosed MM who were treated in the hospital from March 2016 to August 2019 were selected as the research subjects.Data such as ALC,AMC and LMR were collected,and the overall survival(OS)was statistically analyzed.Results:①The peripheral blood ALC of the 115 patients with MM was(0.22~13.48)×10^9L^-1,with an average of(1.77±0.45)×10^9L^-1.The peripheral blood AMC was(0.01~0.98)×10^9L^-1,with an average of(0.45±0.12)×10^9L^-1,and LMR was 1.18~12.74,with an average of 4.74±0.85.②With median values of peripheral blood ALC,AMC and LMR as cut-off values,the patients were grouped.Differences between high ALC group and low ALC group,high AMC group and low AMC group in terms of hemoglobin(Hb),lactate dehydrogenase(LDH),β2-microspheres(β2-MG)were statistically significant(P<0.05).Differences in Hb andβ2-MG between high LMR group and low LMR group were statistically significant(P<0.05).③Kaplan-Meier survival curves showed that the overall OS of high ALC group,low AMC group and high LMR group was significantly longer than that of low ALC group,high AMC group,and low LMR group(P<0.05).④Cox multivariate analysis showed that DS stage III,LDH>245U/L,Hb≤110g/L,ALC≤0.65×10^9L^-1 and LMR≤3.85 were independent risk factors for poor prognosis of patients with initial treatment of MM(P<0.05).Conclusion:ALC,AMC and LMR of patients with MM are related to the clinical data and prognosis.Clinically,the results can be used to initially evaluate and predict the prognosis and guide clinical treatment.