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Clinical impact of the CONUT score in patients with multiple myeloma

  • Sho Okamoto
  • Hiroshi UreshinoEmail author
  • 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
  • Atsushi Kawaguchi
  • Eisaburo Sueoka
  • Shinya Kimura
Original Article

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.

Keywords

Multiple myeloma Prognostic values Controlling nutritional status score Transplant-eligible patients with multiple myeloma 

Notes

Compliance with ethical standards

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.

Informed consent

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

Supplementary material

277_2019_3844_MOESM1_ESM.pdf (52 kb)
ESM 1 (PDF 51 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Sho Okamoto
    • 1
    • 2
  • Hiroshi Ureshino
    • 1
    • 3
    Email author
  • Keisuke Kidoguchi
    • 1
  • Kana Kusaba
    • 1
  • Haruna Kizuka-Sano
    • 1
  • Haruhiko Sano
    • 1
  • Atsujiro Nishioka
    • 1
  • Kyosuke Yamaguchi
    • 1
  • Kazuharu Kamachi
    • 1
  • Hidekazu Itamura
    • 1
  • Mariko Yoshimura
    • 1
  • Masako Yokoo
    • 1
  • Takero Shindo
    • 1
    • 4
  • Yasushi Kubota
    • 1
  • Toshihiko Ando
    • 1
  • Kensuke Kojima
    • 1
  • Atsushi Kawaguchi
    • 5
  • Eisaburo Sueoka
    • 6
    • 7
  • Shinya Kimura
    • 1
    • 3
  1. 1.Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of MedicineSaga UniversitySagaJapan
  2. 2.Department of Internal MedicineSaga-ken Medical Centre KoseikanSagaJapan
  3. 3.Department of Drug Discovery and Biomedical Sciences, Faculty of MedicineSaga UniversitySagaJapan
  4. 4.Department of Hematology and OncologyKyoto University Graduate School of MedicineKyotoJapan
  5. 5.Center for Comprehensive Community Medicine, Faculty of MedicineSaga UniversitySagaJapan
  6. 6.Department of Clinical Laboratory Medicine, Faculty of MedicineSaga UniversitySagaJapan
  7. 7.Department of Laboratory MedicineSaga University HospitalSagaJapan

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