Baseline inflammation indexes and neutrophil‐to‐LDH ratio for prediction of the first mobilization failure without plerixafor‐based regimens in multiple myeloma and lymphoma patients: A single‐center retrospective study

Background Many factors were identified for mobilization failure (MF) in autologous hematopoietic stem‐cell transplantation. To our knowledge, this is the first study to investigate the efficacy of baseline inflammation indexes and neutrophil‐to‐lactate dehydrogenase (LDH) ratio to predict MF in multiple myeloma (MM) and lymphoma. Methods A total of 240 patients with lymphoma or MM hospitalized between January 2014 and June 2022 for the first stem cell mobilization were included in this retrospective single‐center study. We evaluated the impact of baseline demographic, clinical, and laboratory data (before granulocyte colony‐stimulating factor and chemotherapy implementation), including neutrophil, neutrophil‐to‐lymphocyte ratio (NLR), platelet‐to‐lymphocyte ratio, monocyte‐to‐lymphocyte ratio, systemic immune‐inflammation index (SII), systemic inflammatory response index (SIRI), neutrophil‐to‐C‐reactive protein, and neutrophil‐to‐LDH ratios on MF. Results A total of 240 patients were divided into successful (214 patients, 89.16%) and poor mobilizers (26 patients, 10.84%). Poor mobilizers had lower neutrophil, NLR, SII, and neutrophil‐to‐LDH ratios (P values were .001, .022, .001, and .001, respectively). Among these markers, only the neutrophil‐to‐LDH ratio was statistically low in both poor mobilizer MM and lymphoma patients. Receiving operator characteristic curve analysis was performed to evaluate neutrophil, SII, and neutrophil‐to‐LDH ratios for MF. Neutrophil‐to‐LDH ratio had the highest specificity (93.93%, for ≤9.904 cut‐off) compared to the other two variables. Multivariate logistic regression analysis showed that neutrophil‐to‐LDH ratio ≤ 9.904 (cut‐off) (odds ratio: 7.116, P = .001), neutrophil counts ≤3300/mm3 (cut‐off) (odds ratio: 3.248, P = .021), and lymphoma diagnosis (odds ratio: 2.674, P = .039) were independent risks for MF. Conclusion The neutrophil‐to‐LDH ratio could be a novel marker in lymphoma and MM patients to predict the first MF. New studies should be conducted for the optimization of this index.