Abstract:Objective To evaluate the predictive value of fibrinogen-to-lymphocyte ratio（FLR）for early prognosis in patients with newly diagnosed multiple myeloma（MM）. Methods The relevant clinical data before the first treatment were retrospectively collected from MM patients who were newly diagnosed in the Department of Hematology at Affiliated Hospital of Southwest Medical University from September 2018 to April 2024，and were divided into the remission group and the non-remission group based on the efficacy assessment of four courses of treatment. The area under the curve（AUC）and the optimal cut-off value of FLR were determined by using the receiver operating characteristics（ROC）curve，the patients were also divided into high FLR group and low FLR group based on the optimal cutoff value，and the clinical characteristics of MM patients in the high FLR group and low FLR group were analyzed. The independent risk factors affecting the efficacy were analyzed by logistic regression. Results A total of 126 patients with newly diagnosed of MM were included，among which 96 cases were in the remission group and 30 cases were in the non-remission group. The FLR level was 2.12（1.62，3.16）in the remission group and 3.07（2.34，4.64）in the non-remission group，with a statistically significant difference（Z=3.529，P<0.01）. ROC curve analysis showed that the AUC of FLR for predicting the efficacy of newly diagnosed MM patients was 0.714, with an optimal cutoff value of 2.275. The differences in platelet（PLT），complement 3（C3），complement 4（C4），and objective remission rate（ORR）between the high FLR group（n=68）and the low FLR group（n=58）were statistically significant（P<0.05）.Logistic analysis showed that pretreatment FLR was an independent influencing factor for the efficacy of patients with newly diagnosed of MM（OR=1.414，P=0.006）. Conclusion A high FLR is an independent risk factor for the efficacy of newly diagnosed MM patients and can be served as an early prognostic indicator for assessing newly diagnosed patients.