Evidence map›Paper›PMID 41103312›Full record

ArticleFrontiers in nutrition2025

Nutritional status indices on the prognosis of patients with relapsed and refractory multiple myeloma treated with CAR-T cell immunotherapy.

Peng Xu, Yang Liu, Yawen Wang, Qiwen Feng, Huanxin Zhang, Hai Cheng, Kunming Qi, Kailin Xu, Zhenyu Li

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Article in Frontiers in nutrition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

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5citing papers in PubMed
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3 · Its place in the literature

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5 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Peng Xu *Blood Disease Institute, Xuzhou Medical University, Xuzhou, Jiangsu, China.
Yang Liu *Blood Disease Institute, Xuzhou Medical University, Xuzhou, Jiangsu, China.
Yawen WangBlood Disease Institute, Xuzhou Medical University, Xuzhou, Jiangsu, China.
Qiwen FengBlood Disease Institute, Xuzhou Medical University, Xuzhou, Jiangsu, China.
Huanxin ZhangBlood Disease Institute, Xuzhou Medical University, Xuzhou, Jiangsu, China.
Hai ChengBlood Disease Institute, Xuzhou Medical University, Xuzhou, Jiangsu, China.
Kunming QiBlood Disease Institute, Xuzhou Medical University, Xuzhou, Jiangsu, China.
Kailin XuBlood Disease Institute, Xuzhou Medical University, Xuzhou, Jiangsu, China.
Zhenyu LiBlood Disease Institute, Xuzhou Medical University, Xuzhou, Jiangsu, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background aims: Chimeric antigen receptor (CAR) T-cell therapy shows remarkable efficacy against relapsed/refractory multiple myeloma (R/R MM). Nutritional status, assessed by objective indices like the Controlling Nutritional Status (CONUT) and Prognostic Nutritional Index (PNI), influences MM prognosis. However, their predictive value for outcomes following CAR-T therapy in R/R MM remains unclear. Methods: We conducted a retrospective analysis of 181 R/R MM patients receiving CAR-T therapy. Patients were stratified by optimal CONUT (cutoff: 6.5) and PNI (cutoff: 42.75) scores determined via ROC analysis. Associations between CONUT/PNI and treatment outcomes were investigated. Results: Patients with low CONUT or high PNI exhibited significantly improved progression-free survival (PFS) and overall survival (OS) compared to their counterparts (high CONUT or low PNI). While objective response rates (ORR) were high overall (approximately 90-95%), they did not differ significantly between CONUT or PNI subgroups. Importantly, low CONUT or high PNI was associated with faster hematopoietic recovery (red blood cells, hemoglobin, platelets, neutrophils, CD4+, CD8 + T-cells), lower incidence of prolonged hematologic toxicity (PHT), and higher peak CAR transgene levels. No significant differences were observed in cytokine release syndrome (CRS) or immune effector cell-associated neurotoxicity syndrome (ICANS) severity between subgroups. Multivariate analysis confirmed high CONUT as an independent risk factor for inferior PFS and OS, while low PNI was an independent risk factor for inferior PFS. Conclusion: This study establishes pretreatment CONUT and PNI as significant prognostic predictors for R/R MM patients undergoing CAR-T therapy. Patients with low CONUT or high PNI experience superior long-term survival outcomes, potentially linked to enhanced hematopoietic recovery and CAR-T cell expansion. These findings underscore the importance of nutritional assessment in prognostication and may guide future strategies to optimize CAR-T outcomes in R/R MM.

Indexed as

chimeric antigen receptor T cellcontrolling nutritional statusmultiple myelomaprognosisprognostic nutritional index

Identifiers

PMID41103312
PMCPMC12520877

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