Relationship Between Skeletal Muscle Index,prognostic Nutritional Index And Clinical Prognosis Of Patients With Multiple Myeloma

Objective:To explore the relationship between skeletal muscle index,prognostic nutritional index,and clinical prognosis of patients with multiple myeloma.Methods:In this study,the clinical data of 66 patients with multiple myeloma diagnosed and treated in the First Affiliated Hospital of Nanchang University from January 2016 to December 2021 were retrospectively collected.They were divided into groups according to skeletal muscle index and prognostic nutritional index,and their effects on progression-free survival time(PFS)were analyzed.Cox regression analysis was used to screen the factors affecting the progression-free survival time(PFS)of patients with multiple myeloma,and a prognosis prediction model was established.ROC curve,Calibration curve,and decision curve analysis(DCA)were used to evaluate the model,and the nomogram of PFS of patients with multiple myeloma was established.Results:1.There were 21 cases in the low SMI group and 45 cases in the high SMI group.The two groups had statistical differences in males(7,33.3%;28,62.2%;p=0.029)and BMI(20.13±2.27;21.61±2.83;p=0.041).2.The median PFS of 66 patients in survival analysis was 35 months.Among female patients,the prognosis of multiple myeloma patients with low SMI was worse than that of multiple myeloma patients with high SMI(p=0.021),and there was no statistical difference between male patients.3.Multivariate regression analysis showed that low SMI,lactate dehydrogenase,high PNI,and BMI were independent risk factors for the prognosis of patients with multiple myeloma(p<0.05),and the risk of disease progression or death of patients with multiple myeloma with low SMI was 2.2 times higher than that of patients with high SMI.4.A prognostic model of multiple myeloma was established by Cox multivariate regression analysis.The model’s independent variables included high PNI,BMI,low SMI,lactate dehydrogenase,white blood cell count,mSMART-standard risk and mSMART-high risk,and the dependent variable was progression-free survival(PFS).The C index of the receiver operating characteristic(ROC)curve is 0.715(95%Cl:0.599-0.831),and the model’s discrimination,calibration,and clinical validity are verified,and the model has remarkable prediction efficiency.Conclusions:1.The clinical prognosis of patients with multiple myeloma with low skeletal muscle index is worse;2.Patients with multiple myeloma with a low prognostic nutritional index may have a worse clinical prognosis;3.The prognosis prediction model of multiple myeloma constructed in this paper has high accuracy and good clinical application value.