Prognostic nutritional index, but not NLR or PLR, is linked to survival in multiple myeloma
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By
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Nermin Keni Begendi
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Mustafa Duran
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Yaşar Culha
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May 28, 2026
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Clinical Scorecard: Association of Prognostic Nutritional Index with Survival Outcomes in Newly Diagnosed Multiple Myeloma, Unlike NLR and PLR
At a Glance
| Category | Detail |
|---|
| Condition | |
| Key Mechanisms | Prognostic Nutritional Index (PNI), Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR) |
| Target Population | |
| Care Setting | |
Key Highlights
- Low PNI (≤34.7) associated with higher mortality (76.3% vs. 50%)
- Median overall survival shorter in low PNI group (13.5 months vs. 53.3 months)
- NLR and PLR did not show significant prognostic value
- High beta-2 microglobulin levels linked to increased risk of death (3.19-fold)
- Study included 97 patients with a median follow-up of 22.3 months
Guideline-Based Recommendations
Diagnosis
- Diagnosis of MM based on clinical presentation, laboratory findings, bone marrow examination, and imaging studies according to IMWG criteria
Management
Monitoring & Follow-up
Risks
Patient & Prescribing Data
Patients diagnosed with Multiple Myeloma aged ≥18 years
Clinical Best Practices
- Calculate PNI using serum albumin and total lymphocyte count
- Assess NLR and PLR but note their limited prognostic value in MM
- Consider beta-2 microglobulin levels in risk assessment
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