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Prognostic nutritional index, but not NLR or PLR, is linked to survival in multiple myeloma
Nermin Keni Begendi1, Mustafa Duran1, Yaşar Culha2
1Division of Hematology, Department of Internal Medicine, School of Medicine, Afyonkarahisar Health Science University, Afyonkarahisar, Türkiye.
Background:
Multiple myeloma (MM) prognosis is influenced by numerous parameters. The prognostic nutritional index (PNI), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) have emerged as potential prognostic markers in various malignancies.
Objectives:
To evaluate the prognostic significance of PNI, NLR, and PLR in predicting overall survival (OS) in newly diagnosed MM patients.
Methods:
This retrospective study included 97 patients diagnosed with MM at the Hematology Clinic of Afyonkarahisar Health Sciences University between May 2017 and June 2025. PNI, NLR, and PLR values were calculated from baseline laboratory data at diagnosis. Overall survival was analyzed using Kaplan-Meier curves and Cox proportional hazards regression models.
Results:
The median follow-up time was 22.3 months (interquartile range: 6.8-48.0 months). Low PNI (≤34.7) was identified in 38 patients (39.2%). The low PNI group demonstrated significantly higher mortality compared to the high PNI group (76.3% vs. 50%, p = 0.02). Median OS was significantly shorter in the low PNI group compared to the high PNI group (13.5 months vs. 53.3 months, p = 0.007). No significant differences in median OS were observed between low and high PLR or NLR groups. High beta-2 microglobulin (β2M) levels were associated with a 3.19-fold increased risk of death (p = 0.048).
Conclusion:
Low PNI at diagnosis is significantly associated with increased mortality and reduced overall survival in MM patients, whereas NLR and PLR do not demonstrate significant prognostic value in this cohort.
