Akademik Veri Yönetim Sistemi
Transfusion and Apheresis Science, cilt.65, sa.3, 2026 (SCI-Expanded, Scopus)
Background Nutritional status has increasingly been recognized as an important determinant of clinical outcomes in patients with hematologic malignancies. The Controlling Nutritional Status (CONUT) score, which integrates serum albumin, total cholesterol, and lymphocyte count, provides an objective assessment of both nutritional and immunological status. However, the impact of pretransplant CONUT score on hematopoietic engraftment kinetics and clinical outcomes in multiple myeloma patients undergoing autologous stem cell transplantation (ASCT) remains insufficiently characterized. Methods This retrospective study included 314 patients with multiple myeloma who underwent ASCT at a single tertiary center. Patients were stratified into four groups according to pretransplant CONUT score (normal, mild, moderate, and severe malnutrition). Neutrophil and platelet engraftment times were compared across CONUT categories. Additional analyses evaluated the distribution of infused CD34⁺ cell dose and its potential influence on platelet engraftment using Kruskal–Wallis and ANCOVA models. Transfusion requirements, including platelet and red blood cell (RBC) transfusion units and prolonged transfusion dependence beyond day + 14, were also analyzed. Overall survival (OS) was assessed using Kaplan–Meier and Cox proportional hazards models. Results Neutrophil engraftment did not significantly differ across CONUT categories. In contrast, patients with severe malnutrition demonstrated delayed platelet engraftment compared with patients with normal nutritional status. The infused CD34⁺ cell dose differed significantly among CONUT groups, with higher doses observed in patients with normal nutritional status. However, covariance analysis indicated that platelet engraftment was not independently associated with CD34⁺ cell dose after adjustment. Patients with higher CONUT scores required significantly greater numbers of platelet and RBC transfusions and were more likely to require prolonged transfusion support beyond day + 14. In survival analyses, pretransplant treatment response emerged as the strongest independent predictor of OS, whereas the CONUT score was not significantly associated with long-term survival. Conclusion Pretransplant nutritional status assessed by the CONUT score appears to be associated with delayed platelet recovery and increased transfusion requirements following ASCT in patients with multiple myeloma. These findings suggest that the CONUT score may serve as a practical tool for identifying patients at risk for increased early supportive care needs in the post-transplant period.