Clinical impact of the CONUT score in patients with multiple myeloma
Clinical impact of the CONUT score in patients with multiple myeloma
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DOI：
10.1007/s00277-019-03844-2
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发表时间：
2020-01-01
影响因子：
3.5
通讯作者：
Kimura, Shinya
中科院分区：
文献类型：
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作者：
Okamoto, Sho;Ureshino, Hiroshi;Kimura, Shinya
新型抗骨髓瘤药物显著改善了多发性骨髓瘤（MM）患者的总生存期（OS）。然而，并非所有接受这些药物治疗的MM患者都显示出生存获益，生物学和遗传学预后因素不足以预测治疗反应。减少治疗相关并发症对于提高MM患者的治疗效果非常重要。控制营养状态（CONUT）评分是营养状况不良的筛查方法，营养状况不良与几种癌症的预后不良相关，因为它增加了治疗相关并发症的发生率。我们回顾性分析了64例症状性MM患者的OS，并评估了CONUT评分与MM患者预后之间的相关性。诊断时的中位年龄为66岁，多变量分析显示，高CONUT评分（>= 5;危险比，3.937; 95%可信区间，1.214-12.658; P = 0.022）是独立的预后危险因素。根据患者年龄进行亚组分析，因为治疗策略的选择，特别是自体外周血干细胞移植（auto-PBSCT），可能因MM患者的年龄而异。接受auto-PBSCT且CONUT评分较低（0-3）的年轻患者（< 65岁）的生存结局显著优于CONUT评分较高（>= 4）的患者（中位OS，未达到vs. 64.1个月; P = 0.011）。CONUT评分计算简单，为MM患者，尤其是符合移植条件的患者提供了有用的预后指标。
Novel anti-myeloma drugs have significantly improved the overall survival (OS) of patients with multiple myeloma (MM). However, not all MM patients treated with these drugs show survival benefits, and biologic and genetic prognostic factors are insufficient to predict the response to treatment. Decreasing treatment-related complications is important to improve the efficacy of treatment in patients with MM. The Controlling Nutritional Status (CONUT) score is a screening method for poor nutritional status, which is associated with poor prognosis in several cancers because it increases the rate of treatment-related complications. We retrospectively analyzed the OS of 64 patients with symptomatic MM and evaluated the correlation between the CONUT score and patient prognosis in MM. The median age at diagnosis was 66 years, and multivariate analysis showed that a high CONUT score (>= 5; hazard ratio, 3.937; 95% confidence interval, 1.214-12.658; P = 0.022) was an independent prognostic risk factor. Subgroup analysis was performed according to patient age because the choice of treatment strategy, particularly autologous peripheral blood stem cell transplantation (auto-PBSCT), can vary depending on age in MM patients. Younger patients (< 65 years old) who received auto-PBSCT and had a lower CONUT score (0-3) showed a significantly better survival outcome than those with a higher CONUT score (>= 4) (median OS, not reached vs. 64.1 months; P = 0.011). The CONUT score is simple to calculate and provides a useful prognostic indicator in patients with MM, especially transplant-eligible patients.