[Changes in Neutrophil Percentage-to-Albumin Ratio and Its Relationship with Short-Term Prognosis in Patients with Multiple Myeloma Treated with VRD].

Objective: To analyze the dynamic changes of neutrophil percentage-to-albumin ratio (NPAR) during treatment with bortezomib-lenalidomide-dexamethasone (VRD) in patients with multiple myeloma (MM), and explore the relationship between NPAR value and short-term prognosis of MM patients.

Method: The data of 80 MM patients who underwent VRD chemotherapy at Tangshan Workers Hospital from January 2019 to April 2021 were retrospectively analyzed. NPAR levels were measured before VRD chemotherapy (T0), and on the first day of the third (T1), sixth (T2), and eighth (T3) chemotherapy cycles. All patients were followed up for 1 year, with the recurrence, progression, or death occurring within 1 year after the completion of VRD treatment as the endpoint event. The patients were divided into a good prognosis group and a poor prognosis group based on the follow-up results. The changes in NPAR at T0, T1, T2, and T3 in the two groups were statistically analyzed. The restricted cubic spline method was used to analyzed the relationship between NPAR and adverse short-term prognosis in MM patients undergoing VRD chemotherapy.

Results: Among the 80 MM patients, 25 cases (31.25%) had poor short-term prognosis, including 19 cases (23.75%) of progression or recurrence, and 6 cases (7.50%) of all-cause mortality. The levels of neutrophils and NPAR in the poor prognosis group at T0, T1, T2 and T3 were higher than those in the good prognosis group at the same period, while the albumin levels in the poor prognosis group at T0, T1, and T2 were lower than those in the good prognosis group at the same period (P < 0.05); There was no significant difference in albumin levels between the poor prognosis group and the good prognosis group at T3 (P >0.05). Within the poor prognosis group and the good prognosis group, the levels of neutrophils and NPAR decreased sequentially at T0, T1, T2, and T3, while the levels of albumin increased sequentially, and the differences between each stage were statistically significant (P < 0.05). The restricted cubic spline model showed an approximate J-shaped curve between the risk of poor short-term prognosis and the pre-treatment NPAR level in MM patients (P < 0.05). If the pre-treatment NPAR>0.52, the risk of poor short-term prognosis in MM patients increased with the increase of NPAR value.

Conclusion: After VRD treatment, the NPAR value of MM patients gradually decreases, and there is a correlation between the NPAR value before VRD treatment and the risk of poor prognosis after treatment. If NPAR>0.52 before treatment, the higher the NPAR value, the higher the risk of poor short-term prognosis in MM patients.