A RECENT study has highlighted the potential of using peripheral blood absolute lymphocyte count (ALC) as a biomarker for assessing immune status and predicting survival outcomes in multiple myeloma (MM) patients. The research, which examined 11,427 patients diagnosed with MM between 2000 and 2019 at Veterans Administration hospitals, found that lymphopenia—characterised by low ALC—was significantly associated with inferior overall survival (OS).
Patients were grouped into three ALC categories: severely low (<1 × 103/μL), low (1 × 103/μL to 1.5 × 103/μL), and normal (>1.5 × 103/μL). The study revealed that 53% of MM patients had lymphopenia at diagnosis, and those with severely low ALC had a median OS of just 2.7 years, compared to 3.3 years for those with low ALC, and 4.2 years for those with normal ALC. The results suggest that lower lymphocyte counts at diagnosis correlate with poorer survival outcomes.
Additionally, the research found that lymphopenia, whether present at diagnosis or developing during treatment, continued to be a predictor of worse survival, highlighting the critical role of the immune microenvironment in disease progression. These findings support the use of ALC as a simple yet effective tool for risk stratification in MM, particularly as immune-based therapies continue to advance.
This study underscores the importance of immune status in guiding treatment decisions and could lead to better tailored therapies for MM patients in the future.
Helena Bradbury, EMJ
Reference
Ferri GM et al. Lymphopenia predicts poor outcomes in newly diagnosed multiple myeloma. Blood Adv. 2025;9(1):78-88.
