# Exploring the prognostic value of combined assessment of bone marrow plasma cell morphology, Vitamin D, and interleukin-6 in multiple myeloma

## TL;DR

This study shows that combining bone marrow plasma cell analysis with Vitamin D and IL-6 levels can predict outcomes in multiple myeloma patients, potentially improving local healthcare access.

## Contribution

The novelty lies in combining plasma cell morphology with Vit D and IL-6 for a more accurate MM prognosis assessment.

## Key findings

- Combined detection of plasma cell morphology, Vit D, and IL-6 showed an AUC of 0.835 for prognosis.
- Vit D positively correlated with ALB, while IL-6 negatively correlated with HGB.
- Plasma cell count and IL-6 levels increased before chemotherapy compared to after.

## Abstract

The study aims to explore the prognostic assessment value of bone marrow plasma cell morphology, Vitamin D (Vit D), and Interleukin-6 (IL-6) in patients with Multiple Myeloma (MM), with the potential to provide local medical care for follow-up patients and indirectly alleviate the difficulty of accessing healthcare in higher-level hospitals.

Clinical data were collected from 111 MM patients admitted to the Department of Hematology, The First Affiliated Hospital of Chongqing Medical University, between January 2022 and December 2024. The morphological characteristics of plasma cells in different stages of the disease were analyzed in patients with poor prognosis. The correlations between the number of plasma cells, Vit D, IL-6, laboratory indicators, and disease stages were investigated. Receiver Operating Characteristic (ROC) curves were plotted based on follow-up data to assess the prognostic value of these three indicators in MM.

The heterogeneity of plasma cell morphology is evident in MM patients, and there are significant differences in the number of plasma cells between the Durie-Salmon Staging System (DS) and the International Staging System (ISS) (p < 0.05). There were marked differences in bone marrow plasma cell count, Vit D levels, and IL-6 levels across different stages (p < 0.05). The number of bone marrow plasma cells and IL-6 levels before chemotherapy were significantly higher than those after chemotherapy, with statistically significant differences (p < 0.05). Vit D positively correlated with Serum Albumin (ALB) (r = 0.581, p < 0.05), while IL-6 negatively correlated with Hemoglobin (HGB) (r = −0.556, p < 0.05). The number of bone marrow plasma cells and IL-6 levels positively correlated with DS stages in MM patients (r = 0.4466, 0.6347, p = 0.0001, <0.0001, respectively). Vit D negatively correlated with DS stages in MM patients (r = −0.6312, p < 0.0001). The combined detection AUC of 0.835 was superior to that of IL-6 (z = 2.148, p = 0.032) and Vit D (z = 1.978, p = 0.042) alone.

Combined detection of bone marrow cellular morphology, Vit D, and IL-6 can provide effective prognostic monitoring for MM patients, potentially offering local follow-up care, reducing economic burdens, and improving quality of life.