Prognostic value of PINI index in patients with multiple myeloma

被引:20
作者
Dupire, Sophie [1 ,2 ]
Wemeau, Mathieu [1 ]
Debarri, Houria [1 ]
Pascal, Laurent [1 ]
Hivert, Benedicte [1 ]
Willekens, Christophe [1 ]
Boyle, Eileen [1 ]
Manier, Salomon [1 ]
Beatrice, Thielemans [1 ]
Onraed, Brigitte [3 ]
Faucompre, Jean-Luc [3 ]
Hennache, Bernadette [3 ]
Dumontet, Charles [2 ]
Facon, Thierry [1 ]
Leleu, Xavier [1 ]
机构
[1] CHU Lille, Serv Malad Sang, Hop Huriez, F-59037 Lille, France
[2] Hosp Civils Lyon, Serv Hematol, Ctr Hosp Lyon Sud, Lyon, France
[3] CHU Lille, Dept Biochim Prot, Ctr Biol Pathol, F-59037 Lille, France
关键词
Myeloma; PINI; prognostic marker; NUTRITIONAL INDEX; ELDERLY-PATIENTS; CANCER-PATIENTS; INTERLEUKIN-6; MANAGEMENT; PROTEINS;
D O I
10.1111/j.1600-0609.2011.01740.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The Prognostic Inflammatory and Nutritional Index (PINI) is a simple scoring system that aggregates two blood markers of inflammatory [C-reactive protein (CRP) and orosomucoid] and of nutritional (albumin and prealbumin) states. It is used in routine practice in geriatric medicine, especially in hospitalized elderly patients. This study was undertaken to evaluate the usefulness of PINI index in multiple myeloma (MM), a malignancy of the elderly. Method: The PINI score was determined in 231 previously untreated patients with MM, of whom 112 were 65 yrs old. The serum albumin, prealbumin, orosomucoid (human a1-acid glycoprotein), and hsCRP are measured routinely by immunonephelometry. Results: In the overall population and the elderly subset, PINI 4 (` high PINI') was correlated with a shorter median survival, 26 vs. 65 months in the high and low PINI groups, respectively. The prognostic impact of PINI index was dramatic in the elderly MM subgroup, 6 and 45 months, respectively. The high PINI index also predicted for shorter survival in various groups with good prognostic, such as low International Staging System (ISS) stages, low b2m, and absence of del17p and t(4; 14), further demonstrating its prognostic impact on overall survival. In multivariate analysis, PINI index provided additional survival prognostic information to b2m in a b2m/PINI model. Conclusion: PINI index appears to be a useful and easy-to-perform marker in routine to determine the prognosis of patients with MM, especially in the elderly population. PINI might represent an alternative to ISS score, especially in elderly patients, in the future.
引用
收藏
页码:306 / 313
页数:8
相关论文
共 17 条
  • [1] Evaluation of the nutritional and inflammatory status in cancer patients for the risk assessment of severe haematological toxicity following chemotherapy
    Alexandre, J
    Gross-Goupil, M
    Falissard, B
    Nguyen, ML
    Gornet, JM
    Misset, JL
    Goldwasser, F
    [J]. ANNALS OF ONCOLOGY, 2003, 14 (01) : 36 - 41
  • [2] Multiple myeloma in elderly patients: prognostic factors and outcome
    Anagnostopoulos, A
    Gika, D
    Symeonidis, A
    Zervas, K
    Pouli, A
    Repoussis, P
    Grigoraki, V
    Anagnostopoulos, N
    Economopoulos, T
    Maniatis, A
    Dimopoulos, MA
    [J]. EUROPEAN JOURNAL OF HAEMATOLOGY, 2005, 75 (05) : 370 - 375
  • [3] Role of genetics in prognostication in myeloma
    Avet-Loiseau, Herve
    [J]. BEST PRACTICE & RESEARCH CLINICAL HAEMATOLOGY, 2007, 20 (04) : 625 - 635
  • [4] Bonnefoy M, 1998, INT J VITAM NUTR RES, V68, P189
  • [5] CALDANI C, 1983, B CANCER, V70, P1
  • [6] Duguet A, 1999, B CANCER, V86, P997
  • [7] Management of older patients with multiple myeloma
    Gay, Francesca
    Palumbo, Antonio
    [J]. BLOOD REVIEWS, 2011, 25 (02) : 65 - 73
  • [8] International staging system for multiple myeloma
    Greipp, PR
    San Miguel, J
    Durie, BGM
    Crowley, JJ
    Barlogie, B
    Bladé, J
    Boccadoro, M
    Child, JA
    Harousseau, JL
    Kyle, RA
    Lahuerta, JJ
    Ludwig, H
    Morgan, G
    Powles, R
    Shimizu, K
    Shustik, C
    Sonneveld, P
    Tosi, P
    Turesson, I
    Westin, J
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 2005, 23 (15) : 3412 - 3420
  • [9] Hollinshead AC, 1978, NATL CANC I MONOGR, V49, P187
  • [10] INGENBLEEK Y, 1985, INT J VITAM NUTR RES, V55, P91