The Role Of CONUT Score In Evaluating The Prognosis Of Patients With Multiple Myeloma

Objective:To evaluate the prognostic significance of Controlling Nutritional Status(CONUT)Score in newly diagnosed multiple myeloma(MM)patients.Methods:Collect and retrospectively analyze the clinical data of 82 patients with MM who were definitely diagnosed as MM in the Department of Hematology,the First Hospital of Shanxi Medical University from January 2017 to December 2021 according to the international diagnostic criteria for myeloma,calculate their CONUT scores,and obtain the optimal cutoff value of the CONUT scores through the receiver operating characteristic(ROC)curve.Divide all patients into a high CONUT score group and a low CONUT score group.Compare the age,gender,ISS stage,DS stage,type of M protein and hemoglobin concentration before chemotherapy,lymphocyte count,monocyte count,neutrophil count,platelet count,albumin,globulin,calcium ion,lactate dehydrogenase,β2-Microglobulin,cholesterol between the two group,to explore the impact of the above indicators on the prognosis of newly diagnosed MM patients,and to explore the impact of CONUT score on the prognosis of patients with different age groups,DS stages,and ISS stages.SPSS26.0 was used for statistical analysis,Kaplan Meier method was used to draw survival curves,and chi-square test was used to compare the characteristics of categorical variables between groups,Mann Whitney U test was used to compare the characteristics of non parametric distribution samples between groups,and Cox proportional risk model was used to conduct univariate and multivariate analysis of prognosis.P<0.05 indicates a significant difference.Results:A total of 82 patients with multiple myeloma were collected,including 48 males(58.5%)and 34 females(41.5%),The median age was 66(34-83)years,Ig G type in 34cases(41.5%),Ig A type in 24 cases(29.3%),light chain type in 16 cases(19.5%),Ig D type in 7 cases(8.5%),and non secretory type in 1 case(1.2%).ISS stage I,II,and III were 8(9.7%),25(30.5%),and 49(59.8%),respectively.DS stage I,II,and III were 5(6.1%),3(3.7%),and 74(90.2%),respectively.According to the receiver operating characteristic(ROC)curve,the cutoff value of the CONUT score was 3.5(95% CI:0.546-0.791),the AUC was 0.668,the sensitivity was 86.4%,the specificity was 50.0%,and the Yoden index was 0.364.All patients were divided into a low CONUT group(≤3.5,25 cases,30.5%)and a high CONUT group(>3.5,57 cases,69.5%).The age of the high CONUT score group was lower than that of the low CONUT score group(P=0.007)β2-Microglobulin levels(P=0.019)and globulin levels(P=0.000)are higher,while hemoglobin levels(P=0.002),lymphocyte levels(P=0.008),albumin levels(P=0.000),and cholesterol levels(P=0.000)are lower.Patients in the low CONUT score group and those in the higher CONUT score group have a better overall survival period(OS)(P=0.000),Patients in the low CONUT score group had better prognosis.Univariate analysis showed that age,albumin,globulin,cholesterol,creatinine,and CONUT scores were associated with the prognosis of MM.Multivariate analysis showed that CONUT scores(HR=1.108,95% CI:1.001-1.226,P=0.048)were associated with the prognosis of MM patients.Conclusions:1.The incidence of malnutrition among patients with multiple myeloma is high,reaching 69.5% in this study.2.Patients with higher CONUT scores and lower CONUT scores have higher hemoglobin levels,lymphocyte levels,albumin levels,and cholesterol levels,as well as age,β2-Microglobulin,level and globulin level are lower.3.Regardless of whether it is the elderly group or the young group,the prognosis of MM patients in the high CONUT score group is worse,and for any DS stage and ISS stage of MM patients,the CONUT score has prognostic value.4.CONUT score is an independent risk factor that affects the prognosis of patients with MM.