Prognostic value of peripheral blood lymphocyte subsets in patients with newly diagnosed multiple myeloma
10.3760/cma.j.cn121090-20240830-00329
- VernacularTitle:外周血淋巴细胞亚群在初治多发性骨髓瘤患者中的预后价值
- Author:
Zhaoyun LIU
1
;
Xianghong ZHAO
1
;
Hui LIU
1
;
Kai DING
1
;
Fengping PENG
1
;
Fengjuan JIANG
1
;
Rong FU
1
Author Information
1. 天津医科大学总医院血液内科，天津市骨髓衰竭及癌性造血克隆防治重点实验室，天津市血液病研究所，天津 300052
- Publication Type:Journal Article
- Keywords:
Multiple myeloma;
Lymphocyte subsets;
Prognosis;
Immune risk score
- From:
Chinese Journal of Hematology
2025;46(6):551-557
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the prognostic value of peripheral blood lymphocyte subsets in patients with newly diagnosed multiple myeloma (NDMM) .Methods:The study retrospectively analyzed 133 patients with NDMM admitted to the General Hospital of Tianjin Medical University General Hospital between 2017 and 2022. The least absolute shrinkage and selection operator (LASSO) regression was used to screen the predictive subgroups from the peripheral blood lymphocyte subsets, and the optimal cutoff value was calculated through receiver operating characteristic curve analysis. A nomogram was constructed based on the results of the multiple-factor analysis, and the predictive performance of the nomogram was evaluated by the concordance index and calibration curve. Kaplan-Meier curves and log-rank tests were conducted to compare the differences in overall survival (OS) and progression-free survival between the high-risk and low-risk immune risk scores groups.Results:Using LASSO regression, the percentages and absolute counts of CD16 +CD56 + NK cells, CD3 + T lymphocytes, CD3 +CD8 + T lymphocytes, and CD3 -CD19 + B lymphocytes were selected as predictive subgroups. The immune risk score of patients with NDMM was calculated based on the coefficients of each lymphocyte subgroup. The area under the curve of the immune risk score was 0.737, and the optimal cutoff value was -1.834. Based on this, the patients were divided into high-risk and low-risk groups. Survival analysis showed a significant difference in the 3-year OS rate between the high-risk and low-risk immune risk score groups (87.4% vs 49.0%, P<0.001), and a significant difference in the 3-year OS rate between the high-risk and low-risk immune risk score groups in patients with minimal residual disease negative (100% vs 68.6%, P=0.001). Multivariate analysis showed that serum calcium ( P=0.034), high-risk cytogenetic abnormalities ( P=0.002), and immune risk score ( P<0.001) were prognostic factors for patients with NDMM, and a nomogram was constructed based on these factors. The consistency index of the nomogram was 0.793, and the calibration curve showed good predictive ability. The nomogram can accurately classify the risk of different prognostic staging systems. Conclusions:The combined analysis of lymphocyte subsets in the peripheral blood has an important value in predicting the prognosis of patients with NDMM.
