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.