The predictive value of pan-immune inflammation value combined with albumin-to-globulin ratio for infection during chemotherapy in elderly patients with multiple myeloma

Li Yan; Huang Qin; Lin Siying; Gu Zaili Nur; Wang Zengsheng; Nie Yuling

doi:10.3969/j.issn.1671-6450.2025.12.013

Abstract：Objective To explore the predictive value of pan-immune inflammation value(PIIV)combined with albumin-to-globulin ratio(AGR)for infection during chemotherapy in elderly patients with multiple myeloma.Methods A total of 118 elderly patients with multiple myeloma admitted to the Department of Hematology of Xinjiang Uygur Autonomous Region People's Hospital from February 2022 to March 2024 were selected.The patients were divided into the infection group(30 cases)and the non-infection group(88 cases)based on whether infection occurred during chemotherapy.Multivariate logistic regression analysis was used to identify influencing factors of infection during chemotherapy in elderly patients with multiple myeloma.The receiver operating characteristic curve(ROC)was used to analyze the predictive value of PIIV and AGR for infection during chemotherapy in elderly patients with multiple myeloma.Results The PIIV in the infection group was higher than that in the non-infection group,and the AGR was lower than that in the non-infection group(t/P=21.943/＜0.001,6.854/＜0.001).Multivariate logistic regression analysis showed that CRP ≥ 10 mg/L,high NEUT,high MONO,and high PIIV were independent risk factors for infection during chemotherapy in elderly patients with multiple myeloma[OR(95％CI)=3.052(1.298-7.176),2.190(1.463-3.277),3.081(2.175-8.726),1.035(1.011-1.579)],while ECOG score≤2 points,high LYM,and high AGR were protective factors[OR(95％CI)=0.416(0.179-0.967),0.055(0.015-0.193),0.233(0.227-0.923)].The AUC of PIIV,AGR and their combination in predicting infection during chemotherapy in elderly patients with multiple myeloma was 0.850,0.824 and 0.933,respectively.The combination of the two was superior to the individual predictive value of each(Z/P=2.951/0.003,3.562/＜0.001).Conclusion PIIV combined with AGR has good predictive value for infection during chemotherapy in patients with multiple myeloma,and can effectively identify patients with high-risk infection.