Prognostic Immune Biomarker in Newly Diagnosed Multiple Myeloma
The ratio of absolute lymphocyte count (ALC) to absolute monocyte count (AMC) in the peripheral blood appears to serve as a prognostic immune biomarker in newly diagnosed patients with multiple myeloma and may reflect the immunologic status of these patients, wrote Talib Dosani, MD, of Case Western Reserve University/University Hospitals Cleveland Medical Center, and colleagues, in the Blood Cancer Journal.
“Our study is novel in that we show that the ALC/AMC is a more robust prognostic biomarker than ALC alone, as it assesses the relative strength of the host immune system to myeloma-induced immune dysfunction,” the investigators reported.
The retrospective study included 372 patients diagnosed with multiple myeloma between 2004 and 2014. After a median follow-up of 37.5 months, patients with baseline ALC/AMC ≥ 3.6 (N=236) versus ALC/AMC < 3.6 (N=136) experienced longer median progression-free (43 months vs. 24 months, respectively) and median overall survival (62 months vs. 48 months, respectively).
The clinical implications of these findings indicate the ALC/AMC may help to stratify patients based on their baseline immune status. The authors believe that ongoing and future studies may use this “readily available biomarker” to identify treatment-naive patients with multiple myeloma who might benefit from immunotherapy.