Serum ferritin can serve as a biomarker for the prognosis and increased the prognostic predictive value of ISS/RISS in multiple myeloma patients.

Purpose: Multiple myeloma (MM) is a terminally differentiated plasma cell hematological malignancy. The revised international staging system (RISS) is commonly used in patients with de novo MM, but it has limitations in predicting prognosis. Better biomarkers need to added to the staging system.

Results: This retrospective study included a total of 302 patients. Smooth curve fitting analysis showed that serum ferritin levels were associated with relapse and all-cause death. The K-M curve analysis indicated that MM patients with higher ferritin levels had shorter PFS (p < 0.0056) and OS (p = 0.0014). Multivariate Cox regression analysis also showed MM patients with high serum ferritin had poor PFS (p = 0.0012) and OS (p = 0.0258), with independent correlation. The prediction model of ROC analysis based on Cox regression validated ferritin had a predictive value for PFS and OS, and increased the predictive value of ISS and RISS for OS.

Conclusion: We revealed that baseline serum ferritin levels were associated with prognosis in patients with MM, and patients with higher serum ferritin have poorer PFS and OS. Serum ferritin could increase the prediction value. The study provided a new evidence for searching for prognostic biomarkers in MM patients.