Prognostic Value of Hemoglobin to Red Cell Distribution Width Ratio for Patients with Multiple Myeloma

Abstract

Aim: Multiple myeloma (MM) is a malignant hematological disorder characterized by clonal plasma cell proliferation and is often associated with renal impairment, anemia, and increased mortality. This study aims to determine whether the hemoglobin-to-red cell distribution width ratio (HRR) at the time of diagnosis acts as an independent prognostic factor for overall survival (OS).

Subjects and methods: This study included patients diagnosed with MM between 2017 and 2023 at the University Hospital Center Osijek. Data were obtained from medical records, and statistical analysis was conducted using SPSS 23 and MedCalc Statistical Software version 22.018 with significance set at α= 0.05.

Results: A total of 56 patients with MM were included in the study, consisting of 29 (52%) males and 27 (48%) females. Male patients demonstrated significantly higher HRR values (P = 0.04), with notable variations related to the International Staging System (ISS). Patients with elevated HRR (HR = 0.63) had significantly longer survival rates. The cut-off HRR value for predicting mortality was ≤ 5.09. Receiver operating characteristic (ROC) analysis revealed that 42 patients (75%) had HRR values above 5.09, while 14 (25%) had values ≤ 5.09. Patients with HRR values above 5.09 demonstrated significantly better survival outcomes.

Conclusion: There is a statistically significant difference in HRR values based on sex, ISS, and outcome, in male patients, patients in ISS stage I and survivors exhibiting higher HRR levels. Reduced HRR is associated with poorer outcomes and OS in MM patients, establishing HRR as a straightforward and valuable prognostic indicator for long-term survival in MM.

Key words: hemoglobine, multiple myeloma, prognostic factor