WBC Count and WBC to Hb Ratio Could Predict Short-Term Recurrence Rate in Multiple Myeloma Patients Underwent Autologous Stem Cell Transplantation

Multiple myeloma (MM) is a hematologic malignancy with a variable clinical course. We investigated the prognostic role of routine laboratory factors including CBC indices and serum vitamin D levels to predict MM recurrence after receiving an autologous stem cell transplant (ASCT). 29 patients were enrolled. Before ASCT, demographic data and CBC, serum Cr, and Vit D levels were obtained. Patients underwent bone marrow aspiration (BMA) and biopsy (BMB) before ASCT and pretransplant plasma cell counts were also evaluated. Patients were followed for 6 months and BMA and biopsy were done in the 3rd and 6th month of the follow-up to detect recurrence. Overall, 9 patients were reported to have recurrence. The patient's WBC count mean was 13.3±11.6. WBC count was lower in patients with overall recurrence (P=0.005). Patients were divided into 2 groups according to WBC count (<5.5 109/L and ≥5.5 109/L) and we found that WBC count <5.5 109/L was associated with increased risk of recurrence by 15.2 times (Odds ratio: 15.2, 95%CI: 1.4-168, P=0.005). We also evaluated Wbc to Hb ratio (Wbc/Hb) and found that Wbc/Hb <1 had a significant statistical relationship with overall recurrence (P=0.026) as patients with WBC/Hb <1 were in 9.8 times increased risk of recurrence (Odds ratio:9.8, 95% CI: 2-93.5, P=0.026). pretransplant WBC <5.5 109/L and WBC/Hb <1 were associated with 9.8 and 15.2 times increased risk of myeloma recurrence and could be useful predictive factors for a patient's short-term recurrence.