Optimizing Autologous Stem Cell Transplantation in Multiple Myeloma: The Significance of Pre-Transplant Controlling Nutritional Status Score
Abstract
:1. Introduction
2. Methods
2.1. Study Design and Patient Population
- Patients diagnosed with MM undergoing their first ASCT
- Availability of complete pre-transplant laboratory data, including serum albumin, cholesterol, and lymphocyte counts required for CONUT score calculation
- No use of anti-cholesterol medications in the six months prior to ASCT
- Use of anti-cholesterol medications within six months before ASCT
- Missing or incomplete laboratory data needed for CONUT score calculation
- Second or subsequent ASCT procedures
2.2. Treatment Protocols and Supportive Care
2.3. Follow-Up Methodologies
2.4. Engraftment Definitions and Complication Assessment
2.5. CONUT Score Calculation
2.6. Statistical Analysis
3. Results
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Age at transplantation (n = 59) | 61 (54–65) |
Sex (n = 59) | |
Female | 22 (37.29%) |
Male | 37 (62.71%) |
ISS (n = 47) | |
1 | 17 (36.17%) |
2 | 15 (31.91%) |
3 | 15 (31.91%) |
R-ISS (n = 33) | |
1 | 5 (15.15%) |
2 | 21 (63.64%) |
3 | 7 (21.21%) |
Karnofsky Performance Status score (n = 59) | 90 (80–90) |
ECOG Performance Status score (n = 59) | 0 (0–1) |
HCT-CI score (n = 59) | 0 (0–2) |
CONUT score (n = 54) | 2 (2–3) |
Disease status at transplantation (n = 53) | |
CR | 24 (45.28%) |
VGPR | 18 (33.96%) |
PR | 11 (20.75%) |
Stem cell count (×106/kg) (n = 54) | 5.69 (4.60–7.00) |
Conditioning regimen (n = 59) | |
MEL 200 mg/m2 | 44 (74.58%) |
MEL 140 mg/m2 | 15 (25.42%) |
Time between diagnosis and transplantation, months (n = 59) | 7 (5–11) |
Neutrophil engraftment time (n = 59) | 11 (10–11) |
Platelet engraftment time (n = 59) | 12 (10–14) |
Primary graft failure (n = 59) | 0 (0.00%) |
Complication (n = 59) | 13 (22.03%) |
CMV viremia | 1 (1.69%) |
Klebsiella bacteremia | 1 (1.69%) |
E. coli bacteremia | 2 (3.39%) |
E. coli bacteremia + atrial fibrillation | 1 (1.69%) |
Febrile neutropenia | 5 (8.47%) |
Diarrhea | 1 (1.69%) |
Epileptic seizure | 1 (1.69%) |
Transient ischemic attack | 1 (1.69%) |
Oral Mucositis (n = 59) | 6 (10.17%) |
Grade 1 | 3 (5.08%) |
Grade 2 | 2 (3.39%) |
Grade 3 | 1 (1.69%) |
Grade 4 | 0 (0.00%) |
Relapse (n = 59) | 2 (3.39%) |
Mortality (n = 59) | 0 (0.00%) |
Follow-up time after transplantation, months (n = 59) | 3 (2–7) |
Neutrophil Engraftment Time | Platelet Engraftment Time | ||
---|---|---|---|
Age at transplantation | r | −0.069 | −0.008 |
p | 0.604 | 0.949 | |
Sex, Male | r | 0.299 | 0.085 |
p | 0.022 | 0.524 | |
ISS | r | 0.033 | 0.253 |
p | 0.826 | 0.086 | |
R-ISS | r | −0.170 | −0.043 |
p | 0.344 | 0.814 | |
Karnofsky Performance Status score | r | 0.407 | 0.287 |
p | 0.001 | 0.027 | |
ECOG Performance Status score | r | 0.170 | 0.210 |
p | 0.199 | 0.110 | |
HCT-CI score | r | 0.288 | 0.191 |
p | 0.027 | 0.147 | |
CONUT score | r | 0.432 | 0.165 |
p | 0.001 | 0.234 | |
Disease status at transplantation | r | −0.132 | −0.043 |
p | 0.346 | 0.761 | |
Stem cell count (×106/kg) | r | 0.088 | 0.034 |
p | 0.526 | 0.806 | |
Conditioning regimen, MEL140 mg/m2 | r | 0.208 | 0.165 |
p | 0.114 | 0.213 | |
Time between diagnosis and transplantation, months | r | −0.110 | −0.012 |
p | 0.405 | 0.929 |
Unstandardized β | Standard Error | Standardized β | p | 95% Confidence Interval for β | ||
---|---|---|---|---|---|---|
(Constant) | 7.812 | 1.162 | <0.001 | 5.477 | 10.147 | |
Sex, Male | 0.487 | 0.231 | 0.250 | 0.040 | 0.023 | 0.951 |
Karnofsky Performance Status score | 0.020 | 0.014 | 0.174 | 0.179 | −0.009 | 0.049 |
HCT-CI score | 0.166 | 0.080 | 0.243 | 0.043 | 0.006 | 0.327 |
CONUT score | 0.207 | 0.080 | 0.329 | 0.012 | 0.047 | 0.367 |
Complication | |||
---|---|---|---|
Yes (n = 13) | No (n = 46) | p | |
Age at transplantation | 61 (54–64) | 60 (54–65) | 0.769 ‡ |
Sex | |||
Female | 6 (46.15%) | 16 (34.78%) | 0.524 § |
Male | 7 (53.85%) | 30 (65.22%) | |
ISS | |||
1 | 4 (33.33%) | 13 (37.14%) | 0.286 ¶ |
2 | 2 (16.67%) | 13 (37.14%) | |
3 | 6 (50.00%) | 9 (25.71%) | |
R-ISS | |||
1 | 1 (12.50%) | 4 (16.00%) | 0.434 ¶ |
2 | 4 (50.00%) | 17 (68.00%) | |
3 | 3 (37.50%) | 4 (16.00%) | |
Karnofsky Performance Status score | 90 (90–90) | 90 (80–90) | 0.612 ‡ |
ECOG Performance Status score | 0 (0–1) | 0 (0–1) | 0.655 ‡ |
HCT-CI score | 1 (0–2) | 0 (0–2) | 0.766 ‡ |
CONUT score | 2 (2–4) | 2 (2–3) | 0.778 ‡ |
Disease status at transplantation | |||
CR | 6 (46.15%) | 18 (45.00%) | 1.000 ¶ |
VGPR | 4 (30.77%) | 14 (35.00%) | |
PR | 3 (23.08%) | 8 (20.00%) | |
Stem cell count (×106/kg) | 6.03 (5.40–7.30) | 5.60 (4.60–6.68) | 0.442 ‡ |
Conditioning regimen | |||
MEL 200 mg/m2 | 10 (76.92%) | 34 (73.91%) | 1.000 § |
MEL 140 mg/m2 | 3 (23.08%) | 12 (26.09%) | |
Time between diagnosis and transplantation, months | 9 (7–13) | 6 (4–8) | 0.048 ‡ |
Neutrophil engraftment time | 11 (10–11) | 11 (10–11) | 0.695 ‡ |
Platelet engraftment time | 13 (10–15) | 12 (10–13) | 0.214 ‡ |
Relapse | 0 (0.00%) | 2 (4.35%) | 1.000 § |
Follow-up time after transplantation, months | 3 (2–4) | 3.5 (2–7) | 0.839 ‡ |
Oral Mucositis | |||
---|---|---|---|
Yes (n = 6) | No (n = 53) | p | |
Age at transplantation | 63.5 (61–65) | 59 (53–65) | 0.187 ‡ |
Sex | |||
Female | 3 (50.00%) | 19 (35.85%) | 0.661 § |
Male | 3 (50.00%) | 34 (64.15%) | |
ISS | |||
1 | 3 (60.00%) | 14 (33.33%) | 0.599 ¶ |
2 | 1 (20.00%) | 14 (33.33%) | |
3 | 1 (20.00%) | 14 (33.33%) | |
R-ISS | |||
1 | 1 (25.00%) | 4 (13.79%) | 0.593 ¶ |
2 | 3 (75.00%) | 18 (62.07%) | |
3 | 0 (0.00%) | 7 (24.14%) | |
Karnofsky Performance Status score | 90 (80–90) | 90 (80–90) | 0.882 ‡ |
ECOG Performance Status score | 1 (1–1) | 0 (0–1) | 0.090 ‡ |
HCT-CI score | 2 (0–3) | 0 (0–2) | 0.241 ‡ |
CONUT score | 3 (3–4) | 2 (2–3) | 0.028 ‡ |
Disease status at transplantation | |||
CR | 2 (40.00%) | 22 (45.83%) | 0.591 ¶ |
VGPR | 1 (20.00%) | 17 (35.42%) | |
PR | 2 (40.00%) | 9 (18.75%) | |
Stem cell count (×106/kg) | 5.80 (4.60–7.50) | 5.68 (4.70–7.00) | 0.811 ‡ |
Conditioning regimen | |||
MEL 200 mg/m2 | 4 (66.67%) | 40 (75.47%) | 0.638 § |
MEL 140 mg/m2 | 2 (33.33%) | 13 (24.53%) | |
Time between diagnosis and transplantation, months | 4 (1–15) | 7 (6–9) | 0.520 ‡ |
Neutrophil engraftment time | 11 (11–12) | 11 (10–11) | 0.375 ‡ |
Platelet engraftment time | 12 (12–14) | 12 (10–13) | 0.327 ‡ |
Relapse | 0 (0.00%) | 2 (3.77%) | 1.000 § |
Follow-up time after transplantation, months | 5.5 (3–9) | 3 (2–6) | 0.144 ‡ |
Cut-off | >2.5 |
Sensitivity | 100.00% |
Specificity | 57.14% |
Accuracy | 61.11% |
PPV | 19.23% |
NPV | 100.00% |
AUC (95% CI) | 0.792 (0.654–0.930) |
p | 0.033 |
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Özkan, S.G.; Avcı, S.; Kimiaei, A.; Safaei, S.; Altuntaş, Y.; Yüksel Öztürkmen, A.; Aslı Durak, Z.; Özdemir, S.; Adeeb Abbara, M.; Ağyol, T.; et al. Optimizing Autologous Stem Cell Transplantation in Multiple Myeloma: The Significance of Pre-Transplant Controlling Nutritional Status Score. Life 2025, 15, 289. https://doi.org/10.3390/life15020289
Özkan SG, Avcı S, Kimiaei A, Safaei S, Altuntaş Y, Yüksel Öztürkmen A, Aslı Durak Z, Özdemir S, Adeeb Abbara M, Ağyol T, et al. Optimizing Autologous Stem Cell Transplantation in Multiple Myeloma: The Significance of Pre-Transplant Controlling Nutritional Status Score. Life. 2025; 15(2):289. https://doi.org/10.3390/life15020289
Chicago/Turabian StyleÖzkan, Sıdıka Gülkan, Suna Avcı, Ali Kimiaei, Seyedehtina Safaei, Yüksel Altuntaş, Aslı Yüksel Öztürkmen, Zeynep Aslı Durak, Sinem Özdemir, Mohammad Adeeb Abbara, Tuğba Ağyol, and et al. 2025. "Optimizing Autologous Stem Cell Transplantation in Multiple Myeloma: The Significance of Pre-Transplant Controlling Nutritional Status Score" Life 15, no. 2: 289. https://doi.org/10.3390/life15020289
APA StyleÖzkan, S. G., Avcı, S., Kimiaei, A., Safaei, S., Altuntaş, Y., Yüksel Öztürkmen, A., Aslı Durak, Z., Özdemir, S., Adeeb Abbara, M., Ağyol, T., Serdar Yıldız, M., & Özkan, H. A. (2025). Optimizing Autologous Stem Cell Transplantation in Multiple Myeloma: The Significance of Pre-Transplant Controlling Nutritional Status Score. Life, 15(2), 289. https://doi.org/10.3390/life15020289