新诊断多发性骨髓瘤肾损害患者的免疫学特征分析

Objective: To investigate whether there are differences in immunological indicators between multiple myeloma (MM) patients with renal impairment (RI) and those without. Methods: A retrospective analysis was conducted on 134 patients who were admitted to the Second Hospital of Lanzhou University and first diagnosed with MM from January 2017 to August 2023. The study compared the differences in 10 immunological indicators and 6 routine hematological parameters between the RI group and the non-RI group, as well as the Durie-Salmon (DS) staging and risk stratification subgroups. Results: The peripheral blood neutrophil/lymphocyte ratio (NLR), peripheral blood monocyte/lymphocyte ratio (MLR), CD8⁺ T cell ratio, and IL-10 in the RI group were all higher than those in the non-RI group (all P<0.05), while the absolute value of lymphocytes and CD4/CD8 ratio were both lower than those in the non-RI group (both P<0.05). In DS-Ⅲ stage patients, the proportion of NLR, MLR, CD8⁺ T cells, IL-8, and IL-10 in the RI group were all higher than those in the non-RI group (all P<0.05). However, there was no significant difference in immune indicators between the RI and non-RI groups in DS-Ⅰ and DS-Ⅱ patients. The number of lymphocytes, NLR, and IL-10 in the RI group of high-risk MM patients showed significant differences compared to those in non-RI patients (all P<0.05). Conclusion: Immunological abnormalities are more pronounced in MM patients with RI, and significant immune abnormalities are observed in DS-Ⅲ staging and high-risk stratification. The results of this study provide a reference for further elucidating the reasons for poor prognosis in MM patients with RI and personalized treatment.