Review Article

Utility of Routine Hematological Parameters in Monitoring Multiple Myeloma Before and After Autologous Peripheral Blood Stem Cell Transplantation: A Narrative Review

Abstract

Background: Multiple myeloma (MM) is a clonal plasma-cell malignancy, and its diagnosis and monitoring rely mainly on disease specific investigations. Routine hematological tests remain widely available and are frequently performed before and after autologous peripheral blood stem cell transplantation (aPBSCT), particularly in resource-constrained settings. Objective: To evaluate the utility and limitations of complete blood count (CBC), absolute lymphocyte count (ALC), rouleaux formation and erythrocyte sedimentation rate (ESR) in MM before and after aPBSCT, in relation to disease-specific investigations. Methods: A narrative review was undertaken of published studies, international consensus recommendations, clinical trials, systematic reviews and major hematology publications. Evidence was synthesized according to whether each investigation provides disease-specific, prognostic, treatment-monitoring, hematopoietic-recovery or supportive information. Results: CBC parameters remain essential for assessing anemia, cytopenias, treatment-related toxicity and hematological recovery after transplantation. Early post-transplant ALC recovery is associated with improved progression-free and overall survival, but ALC reflects immune and hematological recovery rather than myeloma burden. Rouleaux formation and ESR may reflect altered plasma protein concentrations but are nonspecific. Serum protein electrophoresis, immunofixation, serum free light-chain analysis, bone marrow assessment, imaging and minimal residual disease testing provide substantially more disease-specific information. Conclusions: Routine hematological investigations remain clinically important, particularly for evaluating toxicity, marrow recovery and immune reconstitution. ALC may offer prognostic information after aPBSCT but cannot substitute for disease-specific monitoring, while rouleaux formation and ESR are only supportive. Prospective studies should assess whether ALC and other inexpensive parameters add prognostic value to established biomarkers.

Authors affiliation:

Waduvadeniya Gamachchige Upeksha Nethmini (ORCID): Oyo State College of Health Science and Technology, Eleyele, Ibadan, Oyo State, Nigeria
Koswattage Dinara Sethvindi Perera (ORCID): Lead City University, Public Health Department, Tollgate, Ibadan Lagos Express road, Ibadan, Oyo State, Nigeria.
Sasikala Suresh: Planned Parenthood Federation of Nigeria, 4, Baltic Crescent off Danube Street Maitama, Abuja, Nigeria. 
Rajitha Samarasinghe: Centre for Population and Reproductive Health, College of Medicine, University of Ibadan, Nigeria.
Darshana Udakara Kottahachchi (ORCID): Lead City University, Public Health Department, Toll gate, Ibadan, Lagos, Ibadan Express road, Oyo State, Nigeria.

How To Cite: W.G.U. Nethmini, K.D.S. Perera, S. Suresh, R. Samarasinghe, and D.U. Kottahachchi. Utility of Routine Hematological Parameters in Monitoring Multiple Myeloma Before and After Autologous Peripheral Blood Stem Cell Transplantation: A Narrative Review. Healthcare Issues, 5(2):42–51, 2026. https://doi.org/10.58614/hi527