SYSTEMATIC REVIEW article
Front. Oncol.
Sec. Hematologic Malignancies
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1545096
This article is part of the Research TopicPredicting Prognosis in Chronic Lymphocytic Leukemia in the Contemporary Targeted Therapy Era: Where Do We Stand?View all articles
Prognostic and clinicopathological value of prognostic nutritional index (PNI) in patients with multiple myeloma: a meta-analysis
Provisionally accepted
- 1Deqing County Third People's Hospital, Hangzhou Normal University, Huzhou, China
- 2Huzhou Central Hospital, Huzhou, China
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Background: Prognostic nutritional index (PNI) has been extensively investigated for its effect on forecasting multiple myeloma (MM) survival; however, the conclusions are conflicting. This meta-analysis identified an accurate MM prognosis forecasting role for the PNI. Methods: We systematically searched PubMed, Web of Science, Embase, Cochrane Library, and CNKI databases until July 2, 2025, and evaluated the overall survival (OS) and progression-free survival (PFS) forecasting ability of the PNI by determining pooled hazard ratios (HRs) with 95% confidence intervals (CIs). Results: This study included seven articles involving 1120 participants. From the pooled findings, a lower PNI exhibited a remarkable correlation with unfavorable OS (HR=2.62, 95% CI=1.76–3.89) and shorter PFS (HR=1.52, 95% CI=1.23–1.89, p<0.001) of MM. Additionally, lower PNI was significantly associated with ISS stage III (odds ratio [OR]=1.80, 95% CI=1.19–2.73, p=0.005). However, PNI did not have a marked correlation with sex (OR=1.02, 95% CI=0.71–1.47, p=0.900), age (OR=1.1, 95% CI=0.70–1.93, p=0.558), and lactate dehydrogenase (OR=0.98, 95% CI=0.57–1.69, p=0.955) in MM. The meta-analysis had some limitations, such as retrospective design, small sample size, and inconsistent cut-off values of PNI. Conclusion: Collectively, the present work including 1120 patients showed the relationship between a lower PNI and unfavorable MM OS and PFS. Furthermore, a lower PNI was significantly associated with an advanced ISS stage of MM. The PNI can be a creditable and cost-effective factor for forecasting MM prognosis.
Keywords: Prognostic nutritional index, Multiple Myeloma, Meta-analysis, prognosis, biomarker
Received: 14 Dec 2024; Accepted: 01 Sep 2025.
Copyright: © 2025 Sun, Zhang and Tang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiaohuan Tang, Deqing County Third People's Hospital, Hangzhou Normal University, Huzhou, China
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