{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T16:52:47Z","timestamp":1787590367295,"version":"build-2736575974"},"reference-count":28,"publisher":"Scientific Scholar","content-domain":{"domain":["ijmr.org.in"],"crossmark-restriction":true},"short-container-title":["Indian J Med Res"],"abstract":"<jats:sec>\n<jats:title>Background &amp; objectives<\/jats:title>\n<jats:p>Ferritin levels, crucial for iron homeostasis, may hold prognostic significance in multiple myeloma (MM) due to their responsiveness to inflammation. The objective of this study was to evaluate the prognostic significance of baseline serum ferritin levels in predicting progression-free survival (PFS) and overall survival (OS) in newly diagnosed south Indian patients with multiple myeloma.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>We retrospectively analysed records of 152 newly diagnosed multiple myeloma (NDMM) patients, grouping them by ferritin levels: group 1 with low ferritin (LF) (&lt;300 ng\/ml, n=68) and group 2 with high ferritin (HF) (\u2265300 ng\/ml, n=84). Cox Proportional Hazard Models were used to identify prognostic risk factors for PFS and OS.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>NDMM patients with elevated diagnostic ferritin levels exhibited significantly higher levels of creatinine (<jats:italic>P<\/jats:italic>=&lt;0.0001), lactate dehydrogenase (LDH, <jats:italic>P<\/jats:italic>=0.005), C-reactive protein (CRP, <jats:italic>P<\/jats:italic>=0.02), erythrocyte sedimentation rate (ESR, <jats:italic>P<\/jats:italic>=0.04), rate of disease progression (<jats:italic>P<\/jats:italic>=0.002), and death (<jats:italic>P<\/jats:italic>=0.011), along with a notable decrease in albumin (<jats:italic>P<\/jats:italic>=&lt;0.0001) and haemoglobin (<jats:italic>P<\/jats:italic>=0.04) compared to MM patients with low ferritin levels. Time-to-event analysis revealed shorter PFS (<jats:italic>P<\/jats:italic>=0.0053) and OS (<jats:italic>P<\/jats:italic>=0.014) in the HF group. Elevated ferritin independently predicted progression [HR=2.59, 95% confidence interval (CI): 1.29-5.16, <jats:italic>P<\/jats:italic>=0.006] and was associated with increased mortality risk (HR=2.93, 95% CI: 1.19-7.24, <jats:italic>P<\/jats:italic>=0.02). Hazard ratios for progression and mortality increased with an increase in ferritin levels. Ferritin showed a weak positive correlation with plasma cell per cent (r=0.122, 95% CI: -0.07-0.31). Ferritin also provided better prediction (25.8 and 32.4%) of PFS and OS than CRP (14.7 and 15.8%).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Interpretation &amp; conclusions<\/jats:title>\n<jats:p>High ferritin levels in multiple myeloma are linked to worse prognosis and poor outcomes, highlighting the need for further research to validate and expand these findings<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/ijmr_1065_2024","type":"journal-article","created":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T12:05:35Z","timestamp":1745669135000},"page":"306-314","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Prognostic significance of baseline serum ferritin in newly diagnosed multiple myeloma cases: A retrospective study from southern India"],"prefix":"10.25259","volume":"161","author":[{"given":"Reshmy","family":"G.S.","sequence":"first","affiliation":[{"name":"Department of Biochemistry, Amrita School of Medicine, Amrita institute of medical sciences, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gopika","family":"Vyas","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Amrita School of Medicine, Amrita institute of medical sciences, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mrudula","family":"E.V.","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Amrita School of Medicine, Amrita institute of medical sciences, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neeraj","family":"Sidharthan","sequence":"additional","affiliation":[{"name":"Department of Clinical Haematology, Amrita School of Medicine, Amrita institute of medical sciences, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sajitha","family":"Krishnan","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Amrita School of Medicine, Amrita institute of medical sciences, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Gutjahr","sequence":"additional","affiliation":[{"name":"Department of Health Science Research, Amrita School of Medicine, Amrita institute of medical sciences, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjaly S.","family":"Nair","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Malankara Orthodox Syrian Church Medical College & Hospital, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merin","family":"Mathew","sequence":"additional","affiliation":[{"name":"Department of Health Science Research, Amrita School of Medicine, Amrita institute of medical sciences, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2025,4,24]]},"reference":[{"key":"10.25259\/IJMR_1065_2024\/ref-1","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1053\/j.seminoncol.2016.11.004","article-title":"Multiple myeloma epidemiology and survival: A unique malignancy","volume":"43","author":"Kazandjian","year":"2016","journal-title":"Semin Oncol"},{"key":"10.25259\/IJMR_1065_2024\/ref-2","doi-asserted-by":"crossref","first-page":"e418","DOI":"10.1200\/EDBK_159009","article-title":"Updated diagnostic criteria and staging system for multiple myeloma","volume":"35","author":"Rajkumar","year":"2016","journal-title":"Am Soc Clin Oncol Educ Book"},{"key":"10.25259\/IJMR_1065_2024\/ref-3","doi-asserted-by":"crossref","first-page":"2211","DOI":"10.1097\/01.HS9.0000852192.69260.a2","article-title":"A review of bone marrow biopsies performed at a London teaching hospital: do bone marrows aid diagnosis and at what cost?","volume":"6","author":"Mahbub","year":"2022","journal-title":"Hemasphere"},{"key":"10.25259\/IJMR_1065_2024\/ref-4","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1073\/pnas.0812010106","article-title":"Regulatory effects of ferritin on angiogenesis","volume":"106","author":"Coffman","year":"2009","journal-title":"Proc Natl Acad Sci USA"},{"key":"10.25259\/IJMR_1065_2024\/ref-5","doi-asserted-by":"crossref","first-page":"1917","DOI":"10.1080\/01635581.2021.1982996","article-title":"Are serum ferritin levels a reliable cancer biomarker? A systematic review and meta-analysis","volume":"74","author":"Ram\u00edrez-Carmona","year":"2022","journal-title":"Nutr Cancer"},{"key":"10.25259\/IJMR_1065_2024\/ref-6","doi-asserted-by":"crossref","first-page":"188917","DOI":"10.1016\/j.bbcan.2023.188917","article-title":"A novel view of ferritin in cancer","volume":"1878","author":"Shesh","year":"2023","journal-title":"Biochem Biophys Acta Rev Cancer"},{"key":"10.25259\/IJMR_1065_2024\/ref-7","doi-asserted-by":"crossref","first-page":"2951","DOI":"10.31557\/APJCP.2024.25.8.2951","article-title":"Impact of serum ferritin and iron overload on acute myeloid leukemia outcomes: A systematic review and meta-analysis","volume":"25","author":"Sadighi","year":"2024","journal-title":"Asian Pac J Cancer Prev"},{"key":"10.25259\/IJMR_1065_2024\/ref-8","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1158\/1055-9965.EPI-24-0757","article-title":"Strength in numbers: Identifying a significant association between high serum ferritin 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