SYSTEMATIC REVIEW article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1669878
This article is part of the Research TopicImmunity and Immunotherapy in Multiple MyelomaView all articles
Inflammatory Markers from Routine Blood Tests Predict Survival in Multiple Myeloma: A Systematic Review and Meta-Analysis
Provisionally accepted
- Ningbo Medical Centre Lihuili Hospital, Ningbo, China
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Background: Multiple myeloma (MM) is an incurable hematologic malignancy marked by abnormal plasma cell proliferation. Inflammatory indices derived from routine blood tests—such as neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), red cell distribution width (RDW), RDW-to-platelet ratio (RPR), and hemoglobin-to-RDW ratio (HRR)—have shown prognostic value across cancers. This meta-analysis aimed to evaluate their prognostic significance in MM. Methods: Following PRISMA guidelines, a systematic search of PubMed, Embase, and Web of Science identified eligible studies through January 17, 2025. Pooled hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Sensitivity and subgroup analyses were conducted to assess heterogeneity, and publication bias was evaluated using Egger's and Begg's tests. Results: Twenty-seven studies including 5,009 MM patients were analyzed. Elevated NLR was significantly associated with poor overall survival (OS: HR = 2.06, 95% CI: 1.72–2.47) and progression-free survival (PFS: HR = 1.70, 95% CI: 1.32–2.19), as well as advanced disease stage (OR = 2.85, 95% CI: 1.40–5.80). High RDW and low LMR were similarly linked to worse outcomes (RDW–OS: HR = 1.68; LMR–OS: HR = 0.58). PLR showed no significant association with prognosis. RPR and HRR results were inconsistent due to limited data. Conclusion: NLR, LMR, and RDW are promising prognostic biomarkers in MM, with elevated NLR and RDW and decreased LMR indicating poorer outcomes. PLR, RPR, and HRR require further investigation. These routinely accessible indices may aid in clinical risk stratification and therapeutic decision-making.
Keywords: Multiple Myeloma, NLR, LMR, RDW, prognosis
Received: 20 Jul 2025; Accepted: 21 Oct 2025.
Copyright: © 2025 Luo, Qin, Li, Mei, Wu and Feng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Qiaoping Wu, lhlyywqp@163.com
Xudong Feng, xdfeng@zju.edu.cn
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