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Clinical impact of the CONUT score in patients with multiple myeloma

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Abstract

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.

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Author information

Authors and Affiliations

  1. Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan

    Sho Okamoto, Hiroshi Ureshino, Keisuke Kidoguchi, Kana Kusaba, Haruna Kizuka-Sano, Haruhiko Sano, Atsujiro Nishioka, Kyosuke Yamaguchi, Kazuharu Kamachi, Hidekazu Itamura, Mariko Yoshimura, Masako Yokoo, Takero Shindo, Yasushi Kubota, Toshihiko Ando, Kensuke Kojima & Shinya Kimura

  2. Department of Internal Medicine, Saga-ken Medical Centre Koseikan, Saga, Japan

    Sho Okamoto

  3. Department of Drug Discovery and Biomedical Sciences, Faculty of Medicine, Saga University, Saga, Japan

    Hiroshi Ureshino & Shinya Kimura

  4. Department of Hematology and Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Takero Shindo

  5. Center for Comprehensive Community Medicine, Faculty of Medicine, Saga University, Saga, Japan

    Atsushi Kawaguchi

  6. Department of Clinical Laboratory Medicine, Faculty of Medicine, Saga University, Saga, Japan

    Eisaburo Sueoka

  7. Department of Laboratory Medicine, Saga University Hospital, Saga, Japan

    Eisaburo Sueoka

Authors
  1. Sho Okamoto
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  2. Hiroshi Ureshino
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  3. Keisuke Kidoguchi
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  4. Kana Kusaba
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  5. Haruna Kizuka-Sano
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  6. Haruhiko Sano
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  7. Atsujiro Nishioka
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  8. Kyosuke Yamaguchi
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  9. Kazuharu Kamachi
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  10. Hidekazu Itamura
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  11. Mariko Yoshimura
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  12. Masako Yokoo
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  13. Takero Shindo
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  14. Yasushi Kubota
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  15. Toshihiko Ando
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  16. Kensuke Kojima
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  17. Atsushi Kawaguchi
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  18. Eisaburo Sueoka
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  19. Shinya Kimura
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Corresponding author

Correspondence to Hiroshi Ureshino.

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Conflicts of interest

S.K. received research funding from Celgene, Janssen, Bristol-Myers Squibb, Novartis, Takeda Pharmaceutical Co., LTD, and Ono Pharmaceutical Co., LTD; K.K. has sponsored research agreements with Janssen Research and Development; T.S. received research funding from Celgene. The other authors declare no conflicts of interest.

Ethics approval

This study was approved by the Institutional Review Board of Saga University. All procedures performed in studies involving human participants were in accordance with the ethical standards of institutional and/or national research committees and with the Declaration of Helsinki.

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Informed consent was waived because of the retrospective design of the data collection.

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Okamoto, S., Ureshino, H., Kidoguchi, K. et al. Clinical impact of the CONUT score in patients with multiple myeloma. Ann Hematol 99, 113–119 (2020). https://doi.org/10.1007/s00277-019-03844-2

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