Glasgow Prognostic Score Serves as a Prognostic Factor of Clinical Outcome in Patients with Newly Diagnosed Multiple Myeloma.

Abstract

Purpose: The Glasgow Prognostic Score (GPS), a systemic inflammation-based prognostic model incorporating C-reactive protein (CRP) and serum albumin levels, has been widely validated in solid tumors and several hematologic malignancies. However, its prognostic value in newly diagnosed multiple myeloma (NDMM) remains unclear. This study aimed to evaluate the association between GPS and survival outcomes in NDMM patients.

Patients and methods: We retrospectively analyzed a real-world cohort of 865 NDMM patients. Patients were stratified based on GPS, and overall survival (OS) and progression-free survival (PFS) were assessed by using Kaplan-Meier analysis. Cox proportional hazards models were used to determine the independent prognostic significance of GPS, adjusting for confounding factors. To compare the prognostic stratification capacity of GPS to its two modified variants, the same Kaplan-Meier analysis was applied to evaluate both the modified Glasgow Prognostic Score (mGPS) and the hypersensitivity-modified Glasgow Prognostic Score (Hs-mGPS). Quantitative comparisons utilized area under the curve (AUC) values derived from time-dependent Receiver Operating Characteristic (ROC) analysis.

Results: A higher GPS was significantly associated with inferior OS and PFS in NDMM patients. Multivariate analysis confirmed that GPS was an independent prognostic factor after adjusting for disease stage and other clinical variables. Additionally, patients with elevated GPS scores presented with more advanced disease stages, as reflected by higher Durie-Salmon and International Staging System (ISS) classifications. And GPS exerts better prognostic stratification capacity than mGPS and Hs-mGPS.

Conclusion: The baseline GPS at the time of diagnosis is an independent prognostic factor that negatively relates to the MM patient survival, for which GPS may serve as a supplement tool in risk stratification upon the primary medical assessment.