The Clinical Impact of the Controlling Nutritional Status (CONUT) Score in Patients with Multiple Myeloma

INTRODUCTION: Multiple myeloma (MM) is a blood cancer involving the abnormal growth of clonal plasma cells in the bone marrow. Traditional models for prognosis such as the Revised International Staging System (R-ISS) primarily considers tumor burden and cytogenetic abnormalities, yet it fails to comprehensively capture patients' immune competence and nutritional condition. The CONUT (Controlling Nutritional Status) score is an immuno-nutritional metric derived from measurements of serum albumin, cholesterol concentration, and lymphocyte levels. Our study aimed to investigate the effect of the CONUT score on prognosis in patients with MM.


METHODS: Ninety-one patients with a confirmed diagnosis of MM were included in this retrospective analysis. Individuals were assigned to low (score ≤4), moderate (score 5–8), or high (score ≥9) risk groups based on their CONUT assessment. The relationship between the CONUT score and the R-ISS stage and the presence of plasmacytoma was evaluated using the chi-square test.
RESULTS: According to the CONUT scores, the mean survival time of the patients was 4202 days in the low-risk group, 3665 days in the moderate-risk group, and 987 days in the high-risk group, with the difference between these durations being statistically significant (p=0.002). The presence of plasmacytoma was identified as a factor negatively affecting survival (p=0.037).
DISCUSSION AND CONCLUSION: The CONUT score appears to be a simple and objective parameter that can predict survival in multiple myeloma independently of traditional staging systems. The assessment of nutritional and immunological status, when integrated into risk classification, may contribute to individualized treatment strategies.