The albumin and monoclonal protein ratio as prognostic marker for multiple myeloma in the era of novel agents.

Multiple myeloma (MM) is a heterogeneous disease group regarding prognosis, clinical course, and response to therapeutic interventions. Numerous prognostic factors have been identified however there was no consensus about the best prognostic indicators or the proper staging systems. In a previous study the A/M ratio containing albumin (A) and monoclonal component (M) emerged as reliable predictor of survival duration in patients treated with conventional chemotherapy. In the current retrospective study authors evaluated the prognostic role of this fraction in the era of novel agents. They assessed the A/M ratio prior treatment in 56 newly diagnosed MM patients from the aspect of the survival time. According to the results the A/M being <1 at the diagnosis indicated significantly poorer prognosis both at the 2 years (p = 0,01) and at the 5 years (p = 0,07) survival endpoints. These results proved that A/M ratio remained valuable marker for predicting prognosis in patients treated with proteosome inhibitor and antiangiogenic therapy as well. Authors recommend therefore applying this A/M ratio in further studies for the better pre-treatment stratification.