Abstract: Objective To explore the value of lymphocyte-to-monocyte ratio (LMR) in evaluating the prognosis of multiple myeloma in the elderly aged over 65 years old at the first diagnosis. Methods From January 2014 to January 2019, 81 newly diagnosed elderly patients with multiple myeloma who were admitted to Yixing Hospital of Jiangsu University were enrolled. The number of lymphocytes and monocytes before treatment were collected, and LMR was calculated. The receiver operating characteristic (ROC) curve was used to determine the cutoff value of LMR in predicting the prognosis. All the patients were divided into high LMR group and low LMR group according to the cutoff value. The patients were followed up, and the relationship between LMR and overall survival (OS) and disease-free survival (DFS) was analyzed. Results A total of 75 patients were followed up, with a follow-up success rate of 92.6%. The follow-up time was 12-72 months, with a median follow-up time of 24 months. The results of ROC curve analysis showed that the area under the curve for predicting the death by LMR was 0.78 (P=0.003), with a specificity of 65.2% and a sensitivity of 81.0%, and the LMR cutoff was 0.15. The complete response rate in the low LMR group was lower than that in the high LMR group (26.67% vs 60.00%, P<0.05). The proportion of Durie-Salmon (DS) stage Ⅲ in the low LMR group was higher than that in the high LMR group(P<0.05). The Kaplan-Meier method and Log-rank test showed that the OS, DFS in the low LMR group were shorter than those in the LMR group (P<0.05). Cox multivariate analysis showed that LMR, age, LDH and DS staging were independent factors affecting OS (P<0.05), and LMR, LDH and DS staging were independent influencing factors of DFS in the elderly patients with multiple myeloma (P<0.05). Conclusions LMR has significant value in predicting the prognosis of the elderly patients with newly diagnosed multiple myeloma.

Key words: lymphocyte-to-monocyte ratio, aged, multiple myeloma, death