{"title":"将CRP/白蛋白比率和LDH水平作为多发性骨髓瘤患者预后指标的改良格拉斯哥预后评分：一项回顾性研究","authors":"Mustafa Duran, Nermin Keni Begendi","doi":"10.2147/CMAR.S540819","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate whether integrating the CRP/Albumin Ratio (CAR) and Lactate Dehydrogenase (LDH) levels into the Modified Glasgow Prognostic Score (mGPS) enhances its prognostic accuracy in patients with multiple myeloma (MM).</p><p><strong>Patients and methods: </strong>A single-center retrospective study was conducted on patients diagnosed with multiple myeloma (MM) at Afyonkarahisar Health Sciences University between 2017 and 2023. Demographic, clinical, and laboratory data including mGPS, CAR, LDH, and ISS staging were collected. Survival outcomes were assessed using Kaplan-Meier curves, and Cox regression models were used to determine prognostic factors.</p><p><strong>Results: </strong>Among the 130 patients, the ISS score was the strongest predictor of mortality (HR = 1.63, 95% CI: 1.27-2.09, p = 0.0001). mGPS 2 combined with LDH > 250 IU (HR = 1.96, 95% CI: 1.32-2.92) and CAR > 0.51 (HR = 1.71, 95% CI: 1.16-2.53) were independent risk factors. mGPS alone remained a consistent prognostic marker (HR = 1.42, 95% CI: 1.14-1.77). One-year survival was 50.0% in the mGPS 2 group, dropping to 30.3% at two years. The mGPS 2 + LDH > 250 IU group had the poorest survival (39.5% to 23.3%), followed by the mGPS 2 + CAR > 0.51 group (44.9% to 28.6%). Median PFS was 28.0, 47.0, and 9.0 months in mGPS0, mGPS1, and mGPS2, respectively (p < 0.001), with mGPS2 showing significantly shorter PFS. mGPS2, CAR, LDH, and their combinations were independent predictors of progression. In mGPS2, OS and PFS declined steadily over 36 months, with the lowest long term PFS in the CAR elevated subgroup.</p><p><strong>Conclusion: </strong>Integrating CAR and LDH into the mGPS offers a cost-effective and accessible approach to improve risk stratification in patients with MM. This enhanced model provides a comprehensive assessment of systemic inflammation and tumour burden, supporting its potential use in clinical decision making.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"17 ","pages":"2009-2021"},"PeriodicalIF":2.6000,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449880/pdf/","citationCount":"0","resultStr":"{\"title\":\"Modified Glasgow Prognostic Score Incorporating CRP/Albumin Ratio and LDH Levels as Prognostic Indicators in Patients with Multiple Myeloma: A Retrospective Study.\",\"authors\":\"Mustafa Duran, Nermin Keni Begendi\",\"doi\":\"10.2147/CMAR.S540819\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>This study aimed to evaluate whether integrating the CRP/Albumin Ratio (CAR) and Lactate Dehydrogenase (LDH) levels into the Modified Glasgow Prognostic Score (mGPS) enhances its prognostic accuracy in patients with multiple myeloma (MM).</p><p><strong>Patients and methods: </strong>A single-center retrospective study was conducted on patients diagnosed with multiple myeloma (MM) at Afyonkarahisar Health Sciences University between 2017 and 2023. Demographic, clinical, and laboratory data including mGPS, CAR, LDH, and ISS staging were collected. Survival outcomes were assessed using Kaplan-Meier curves, and Cox regression models were used to determine prognostic factors.</p><p><strong>Results: </strong>Among the 130 patients, the ISS score was the strongest predictor of mortality (HR = 1.63, 95% CI: 1.27-2.09, p = 0.0001). mGPS 2 combined with LDH > 250 IU (HR = 1.96, 95% CI: 1.32-2.92) and CAR > 0.51 (HR = 1.71, 95% CI: 1.16-2.53) were independent risk factors. mGPS alone remained a consistent prognostic marker (HR = 1.42, 95% CI: 1.14-1.77). One-year survival was 50.0% in the mGPS 2 group, dropping to 30.3% at two years. The mGPS 2 + LDH > 250 IU group had the poorest survival (39.5% to 23.3%), followed by the mGPS 2 + CAR > 0.51 group (44.9% to 28.6%). Median PFS was 28.0, 47.0, and 9.0 months in mGPS0, mGPS1, and mGPS2, respectively (p < 0.001), with mGPS2 showing significantly shorter PFS. mGPS2, CAR, LDH, and their combinations were independent predictors of progression. In mGPS2, OS and PFS declined steadily over 36 months, with the lowest long term PFS in the CAR elevated subgroup.</p><p><strong>Conclusion: </strong>Integrating CAR and LDH into the mGPS offers a cost-effective and accessible approach to improve risk stratification in patients with MM. This enhanced model provides a comprehensive assessment of systemic inflammation and tumour burden, supporting its potential use in clinical decision making.</p>\",\"PeriodicalId\":9479,\"journal\":{\"name\":\"Cancer Management and Research\",\"volume\":\"17 \",\"pages\":\"2009-2021\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-09-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449880/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cancer Management and Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/CMAR.S540819\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer Management and Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/CMAR.S540819","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
Modified Glasgow Prognostic Score Incorporating CRP/Albumin Ratio and LDH Levels as Prognostic Indicators in Patients with Multiple Myeloma: A Retrospective Study.
Purpose: This study aimed to evaluate whether integrating the CRP/Albumin Ratio (CAR) and Lactate Dehydrogenase (LDH) levels into the Modified Glasgow Prognostic Score (mGPS) enhances its prognostic accuracy in patients with multiple myeloma (MM).
Patients and methods: A single-center retrospective study was conducted on patients diagnosed with multiple myeloma (MM) at Afyonkarahisar Health Sciences University between 2017 and 2023. Demographic, clinical, and laboratory data including mGPS, CAR, LDH, and ISS staging were collected. Survival outcomes were assessed using Kaplan-Meier curves, and Cox regression models were used to determine prognostic factors.
Results: Among the 130 patients, the ISS score was the strongest predictor of mortality (HR = 1.63, 95% CI: 1.27-2.09, p = 0.0001). mGPS 2 combined with LDH > 250 IU (HR = 1.96, 95% CI: 1.32-2.92) and CAR > 0.51 (HR = 1.71, 95% CI: 1.16-2.53) were independent risk factors. mGPS alone remained a consistent prognostic marker (HR = 1.42, 95% CI: 1.14-1.77). One-year survival was 50.0% in the mGPS 2 group, dropping to 30.3% at two years. The mGPS 2 + LDH > 250 IU group had the poorest survival (39.5% to 23.3%), followed by the mGPS 2 + CAR > 0.51 group (44.9% to 28.6%). Median PFS was 28.0, 47.0, and 9.0 months in mGPS0, mGPS1, and mGPS2, respectively (p < 0.001), with mGPS2 showing significantly shorter PFS. mGPS2, CAR, LDH, and their combinations were independent predictors of progression. In mGPS2, OS and PFS declined steadily over 36 months, with the lowest long term PFS in the CAR elevated subgroup.
Conclusion: Integrating CAR and LDH into the mGPS offers a cost-effective and accessible approach to improve risk stratification in patients with MM. This enhanced model provides a comprehensive assessment of systemic inflammation and tumour burden, supporting its potential use in clinical decision making.
期刊介绍：
Cancer Management and Research is an international, peer reviewed, open access journal focusing on cancer research and the optimal use of preventative and integrated treatment interventions to achieve improved outcomes, enhanced survival, and quality of life for cancer patients. Specific topics covered in the journal include:
◦Epidemiology, detection and screening
◦Cellular research and biomarkers
◦Identification of biotargets and agents with novel mechanisms of action
◦Optimal clinical use of existing anticancer agents, including combination therapies
◦Radiation and surgery
◦Palliative care
◦Patient adherence, quality of life, satisfaction
The journal welcomes submitted papers covering original research, basic science, clinical & epidemiological studies, reviews & evaluations, guidelines, expert opinion and commentary, and case series that shed novel insights on a disease or disease subtype.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
