Geriatric nutritional risk index predicts 10-year survival in patients with multiple myeloma

Multiple myeloma (MM) remains incurable although a subset of patients achieves survival ≥10 years. However, whether nutritional background predicted long-term survival (LTS), which defined as overall survival (OS) over 10 years, or not remains unclear. This retrospective study aimed to identify the clinical and nutritional factors associated with LTS in patients with MM.

We retrospectively analyzed data from 163 patients with newly diagnosed MM aged <80 years between 2009 and 2014. Geriatric nutritional risk index (GNRI) was a nutritious biomarker and calculated by height, weight, and serum albumin.

The perception of LTS was 20.9%. The cutoff of GNRI was defined as 91.715 using receiver operating characteristic curve to predict LTS. High GNRI was associated with low incidence of CRAB symptoms and international staging system III in patient characteristics. In the 4.6-year median follow-up period, 10-year OS rate in high GRNI group was higher than those in the low GNRI group (39.6% vs 27.9%; hazard ratio [HR], 0.667; P = .050). In the multivariate analysis, high GNRI and early progressive disease (PD) were identified as significant prognostic factors for OS (HR, 0.538; P = .049, and HR, 1.848; P = .040, respectively). We explored a new prognostic model using GNRI and early PD status; the 10-year OS rate in patients with high GNRI without early PD were 49.2%. High GNRI was independent predictors of LTS, and predicted long OS combining with early PD.

The prognostic significance of host nutritional status played an important role for long survival.