Geriatric nutritional risk index for the prediction of venous thrombotic events in multiple myeloma

The geriatric nutritional risk index (GNRI) is an indicator of nutritional status and predicts overall survival (OS) in patients with myeloma. A low GNRI score indicates malnutrition associated with venous thromboembolism (VTE). This retrospective study aimed to investigate the clinical relevance of GNRI in VTE in patients with myeloma.

We reviewed the medical records of 357 patients who were newly diagnosed with myeloma and treated with proteasome inhibitors and/or immunomodulatory drugs. VTE included deep vein thrombosis and pulmonary embolism diagnosed using imaging studies. The cutoff value for the GNRI was 92, according to previous studies.

The median age of the patients was 71 years. The 1-year cumulative incidence of VTE was 4.9%. The median time from diagnosis to VTE was 2.8 months (range, 0.1-86.8 months). A low GNRI was associated with a high incidence of VTE (hazard ratio [HR], 3.885; P < 0.001). During a median follow-up of 37.8 months, OS was significantly shorter in patients with low GNRI scores and those who developed VTE within 1 year than in those with high GNRI scores who did not develop VTE (log-rank test, P < 0.001 and P = 0.047, respectively). Multivariate analysis revealed that low GNRI (HR, 1.562; P = 0.050) and VTE within 1 year (HR, 3.470; P = 0.017) were associated with shorter OS.

A low GNRI score is associated with a high incidence of VTE in patients with myeloma. The GNRI and VTE within 1 year were associated with mortality.