Is the CONUT score a prognostic index in multiple myeloma?

Year 2025, Volume: 18 Issue: 3, 628 - 636, 02.07.2025

Eda Nilufer Coskun , Gulsum Akgun Cagliyan

https://doi.org/10.31362/patd.1650758

Abstract

patients with multiple myeloma (MM).
Materials and methods: Our study was designed retrospectively. We calculated the CONUT score based on serum albumin, total cholesterol and lymphocytes. The study included 213 patients; 99 (46.5%) were female and 114 (53.5%) were male. The median follow-up period was 38 months (1-161).
Results: The median age was 64 years. We participated the patients into four groups. It was defined as CONUT scores: normal (0-1), low (2-4), moderate (5-8), and high (9-12). We found significant differences between overall survival (OS) and progression-free survival (PFS) with regard to CONUT score, respectively, as high (OS:12, PFS:1 months), moderate (OS:27, PFS:13 months) and low (OS:54, PFS:28 months) (p<0.001 and p=0.001). In the multivariate analysis for OS, having moderate CONUT score (HR: 2.21, p=0.005) and high CONUT score (HR: 2.38, p=0.033) were increased the risk of mortality. In the multivariate analysis for PFS, compared to a normal CONUT score, a moderate CONUT score (HR: 1.85, p=0.007), and a high CONUT score (HR: 2.01, p=0.043) were found to increase the risk of progression.
Conclusion: We found that a high CONUT score is related to decreased OS and PFS. In our study, we showed that the CONUT score is an independent, useful and strong prognostic index in MM.

Keywords

CONUT score, multiple myeloma, survival, prognosis

CONUT skoru multipl myelomda prognostik bir gösterge midir?

Abstract

Amaç: Multiple Myelom (MM) hastalarında CONUT skorunun prognoza etkisini değerlendirmeyi amaçladık.
Gereç ve yöntem: Çalışmamız retrospektif bir çalışma olarak tasarlandı. CONUT skorunu serum albumin, total kolesterol ve lenfosit değerlerine göre hesapladık. Bu çalışmaya 99'u (%46,5) kadın, 114'ü (%53,5) erkek olmak üzere 213 hasta dahil edildi. Median takip süresi 38 ay idi (1-161).
Bulgular: Median yaş 64 idi. Hastaları CONUT skoruna göre dört gruba ayırdık: normal (0-1), düşük (2-4), orta (5-8) ve yüksek (9-12). CONUT skoruna göre genel sağkalım (OS) ve progresyonsuz sağkalım (PFS) arasında sırasıyla yüksek (OS:12, PFS:1 ay), orta (OS:27, PFS:13 ay) ve düşük (OS:54, PFS:28 ay) anlamlı farklar bulduk (p<0,001 ve p=0,001). OS için yapılan çok değişkenli analizde CONUT skorunun orta düzeyde olması 2,21 kat (HR:2,21, p=0,005), CONUT skorunun yüksek olması 2,38 kat (HR:2,38, p=0,033) mortalite riskini arttırıyordu. PFS için yapılan çok değişkenli analizde normal CONUT düzeyiyle karşılaştırıldığında orta derecede CONUT skorunun (HR:1,85, p=0,007), yüksek CONUT skorunun (HR:2,01, p=0,043) ilerleme riskini arttırdığı belirlendi.
Sonuç: Yüksek CONUT skorunun OS ve PFS'de azalma ile ilişkili olduğunu belirledik. Çalışmamızda CONUT skorunun MM’da bağımsız, güçlü bir prognostik indeks olduğunu gösterdik.

Keywords

CONUT skor, multipl myelom, sağkalım, prognoz

References

• Colmone A, Amorim M, Pontier AL, Wang S, Jablonski E, Sipkins DA. Leukemic cells create bone marrow niches that disrupt the behavior of normal hematopoietic progenitor cells. Science. 2008;322(5909):1861-1865. doi:10.1126/science.1164390
• Siegel RL, Giaquinto AN, Jemal A. Cancer statistics, 2024 [published correction appears in CA Cancer J Clin. 2024 Mar-Apr;74(2):203. doi:10.3322/caac.21830.]. CA Cancer J Clin. 2024;74(1):12-49. doi:10.3322/caac.21820
• Bladé J, Kyle RA. Multiple myeloma in young patients: clinical presentation and treatment approach. Leuk Lymphoma. 1998;30(5-6):493-501. doi:10.3109/10428199809057562
• Kumar SK, Dispenzieri A, Lacy MQ, et al. Continued improvement in survival in multiple myeloma: changes in early mortality and outcomes in older patients. Leukemia. 2014;28(5):1122-1128. doi:10.1038/leu.2013.313
• Greipp PR, San Miguel J, Durie BG, et al. International staging system for multiple myeloma [published correction appears in J Clin Oncol. 2005 Sep 1;23(25):6281. Harousseau, Jean-Luc [corrected to Avet-Loiseau, Herve]]. J Clin Oncol. 2005;23(15):3412-3420. doi:10.1200/JCO.2005.04.242
• Palumbo A, Avet-Loiseau H, Oliva S, et al. Revised International Staging System for Multiple Myeloma: A Report From International Myeloma Working Group. J Clin Oncol. 2015;33(26):2863-2869. doi:10.1200/JCO.2015.61.2267
• Ignacio de Ulíbarri J, González-Madroño A, de Villar NG, et al. CONUT: a tool for controlling nutritional status. First validation in a hospital population. Nutr Hosp. 2005;20(1):38-45.
• Kuroda D, Sawayama H, Kurashige J, et al. Controlling Nutritional Status (CONUT) score is a prognostic marker for gastric cancer patients after curative resection. Gastric Cancer. 2018;21(2):204-212. doi:10.1007/s10120-017-0744-3
• Formiga F, Chivite D, Corbella X. Utility of the Controlling Nutritional Status (CONUT) score in patients admitted due to acute heart failure. Int J Cardiol. 2017;235:203. doi:10.1016/j.ijcard.2017.02.031
• Huo Q, He T, Xiong J, Zhao J. Controlling nutritional status score is associated with renal progression, cardiovascular events, and all-cause mortality in biopsy-proved diabetic kidney disease. Front Physiol. 2023;14:1231448. Published 2023 Aug 7. doi:10.3389/fphys.2023.1231448
• Zhang Y, Kong FF, Zhu ZQ, Shan HX. Controlling Nutritional Status (CONUT) score is a prognostic marker in III-IV NSCLC patients receiving first-line chemotherapy. BMC Cancer. 2023;23(1):225. Published 2023 Mar 9. doi:10.1186/s12885-023-10682-z
• Zhang Y, Chen Q, Lu C, Yu L. Prognostic role of controlling nutritional status score in hematological malignancies. Hematology. 2022;27(1):653-658. doi:10.1080/16078454.2022.2078040
• Russell SJ, Rajkumar SV. Multiple myeloma and the road to personalised medicine. Lancet Oncol. 2011;12(7):617-619. doi:10.1016/S1470-2045(11)70143-7
• Nagata A, Kanemasa Y, Sasaki Y, et al. Clinical impact of controlling nutritional status score on the prognosis of patients with diffuse large B-cell lymphoma. Hematol Oncol. 2020;38(3):309-317. doi:10.1002/hon.2732
• Akgün Çağlıyan G, Hacıoğlu S, Ünver Koluman B, et al. Is CONUT score a prognostic index in patients with diffuse large cell lymphoma?. Turk J Med Sci. 2021;51(4):2112-2119. Published 2021 Aug 30. doi:10.3906/sag-2101-406
• Ureshino H, Kusaba K, Kidoguchi K, et al. Clinical impact of the CONUT score and mogamulizumab in adult T cell leukemia/lymphoma. Ann Hematol. 2019;98(2):465-471. doi:10.1007/s00277-018-3502-7
• Senjo H, Onozawa M, Hidaka D, et al. A novel nutritional index "simplified CONUT" and the disease risk index independently stratify prognosis of elderly patients with acute myeloid leukemia. Sci Rep. 2020;10(1):19400. Published 2020 Nov 10. doi:10.1038/s41598-020-76250-8
• Okamoto S, Ureshino H, Kidoguchi K, et al. Clinical impact of the CONUT score in patients with multiple myeloma. Ann Hematol. 2020;99(1):113-119. doi:10.1007/s00277-019-03844-2
• Zhou X, Lu Y, Xia J, Mao J, Wang J, Guo H. Association between baseline Controlling Nutritional Status score and clinical outcomes of patients with multiple myeloma. Cancer Biomark. 2021;32(1):65-71. doi:10.3233/CBM-210073