Prognostic value of PINI index in patients with multiple myeloma

Dupire, Sophie; Wémeau, Mathieu; Debarri, Houria; Pascal, Laurent; Hivert, Bénédicte; Willekens, Christophe; Boyle, Eileen M.; Manier, Salomon; Thielemans, Béatrice; Onraed, Brigitte; Faucompré, Jean-Luc; Hennache, Bernadette; Dumontet, Charles; Façon, Thierry; Leleu, Xavier

doi:10.1111/j.1600-0609.2011.01740.x

Cited by 21 publications

(19 citation statements)

References 10 publications

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“…Iverson et al 20 reported transient decreases in the nutritional status of myeloma patients using anthropometric (eg, BMI) and biomarker data (eg, serum albumin, serum transferrin, Vitamins D and E), signifying acute fluctuations and perhaps the limitations of these nutritional status measures. More recently, Dupire et al found the Prognostic Inflammatory and Nutritional Index (PINI) was useful for the determining the prognosis of patient with myeloma 21 ; however, this tool largely relies on acute phase proteins which are not considered valid nutritional status markers 22 . Because clinical practice lacks a universal tool to decipher malnourished patients from those that are ‘normally’ nourished, this committee recommendation remains limited.…”

Section: Discussionmentioning

confidence: 99%

Incident hyperglycemia, parenteral nutrition administration and adverse outcomes in patients with myeloma admitted for initial auto-SCT

Sheean

Kilkus

Liu

et al. 2013

Bone Marrow Transplant

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Parenteral nutrition (PN) exacerbates hyperglycemia, which is associated with increased morbidity and mortality in various cancer populations. Using a retrospective design, we examined incident hyperglycemia in PN and non-PN recipients and the associations with clinical events and 5-year survival in a cohort treated for myeloma with melphalan and auto-SCT (n=112). Clinical comparisons were made at admission, and “before” and “after” initiating PN to discern differences and temporality. Actual infusion times were used for PN patients; timeframes based on mean PN infusion days were created for the non-PN recipients. Oral intake was lower “before” in PN vs. non-PN patients (p=<0.001); however, no differences in mucositis, emesis, infections or transfusions were detected “before.” Incident hyperglycemia (≥7.0 mmol/L) was significant “after” PN initiation, and PN recipients experienced delays in WBC (p<0.05) and platelet engraftment (p= 0.009) and required significantly greater RBC (p=0.0014) and platelet (p=0.001) support “after” than non-PN patients. Neutropenic fever and longer hospital stay were more frequent among PN vs. non-PN recipients (p<0.001). Differences in 5-year mortality were not apparent. Findings fail to support clinical benefits of PN administration during auto-SCT for myeloma. Further study is needed to discern if hyperglycemia or feeding per se was deleterious in this patient population.

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Section: Discussionmentioning

confidence: 99%

Incident hyperglycemia, parenteral nutrition administration and adverse outcomes in patients with myeloma admitted for initial auto-SCT

Sheean

Kilkus

Liu

et al. 2013

Bone Marrow Transplant

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“…The Prognostic Inflammatory and Nutritional Index (PINI) combining orosomucoid, CRP, prealbumin, and albumin levels has been proposed as a solution [24, 25, 26]. Unfortunately, large and rapid changes in CRP in acute inflammation overestimate the values of PINI.…”

Section: Potential Biomarkers To Detect Malnutrition and To Monitor Tmentioning

confidence: 99%

“…Unfortunately, large and rapid changes in CRP in acute inflammation overestimate the values of PINI. Additionally, a decrease of orosomucoid is observed in hepatocellular insufficiency, acute kidney injury, with some medications (corticosteroids, NSAIDs, erythromycin, penicillin, α-and beta-blockers, sulfasalazine) and in terminal stages of some neoplasias, which makes it an unreliable parameter [25]. As a result, the question remains about the interest of other inflammatory scores in this context [27, 28].…”

Section: Potential Biomarkers To Detect Malnutrition and To Monitor Tmentioning

confidence: 99%

Biomarkers in immunonutrition programme, is there still a need for new ones? A brief review

Forget

Echeverria

Giglioli

et al. 2015

ecancer

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Background and aimsPre-existing malnutrition is one the most important factors affecting postsurgical complications, especially in cancer patients. The consequences of this on the immune function as well as on outcome could be reversed by immunonutrition. To help the clinician as a researcher, a routinely available biomarker (derived from clinical or biological data) would be of great importance.MethodsWe reviewed the potential markers that may routinely be used in perioperative immunonutrition programmes. A comprehensive approach was used to identify and discuss the potential markers, focusing on body mass and serum biomarkers.ResultsBody mass (including weight loss and body mass index) are predictive of complications, but not specifically to malnutrition. Serum markers, such as albumin, transthyretin, white blood cells counts, and C-reactive protein are not more specific. Composite scores, including the Nutritional Risk Index (NRI), the Prognostic Inflammatory and Nutritional Index (PINI), the modified Glasgow Prognostic Score (mGPS), the neutrophil-to-lymphocyte ratio (NLR), CD4 and CD8 lymphocytes counts, the platelet-to-lymphocyte ratio (PLR), the Prognostic Index (PI), and the Prognostic Nutritional Index (PNI) are prognostic factors of outcome, but are not always correlated to immunonutrition effect.ConclusionsIn conclusion, there remains a lack of efficient and widely available monitoring of the effects of immunonutrition. To predict and monitor the effect of immunonutrition on immunity, efforts should be directed to the validation of routinely available tools to aid the implementation of advanced immune monitoring (like lymphocytes subpopulations counts) in clinical practices.

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“…In a retrospective analysis, among 231 patients with myeloma (including 112 patients aged over 65) a PINI score ≥4 was associated with a shorter survival regardless of the cytogenetic profile [92]. This should prompt early intervention studies to improve outcomes in this population.…”

Section: Nutritionmentioning

confidence: 99%

Handbook of Multiple Myeloma

Mohty¹,

Harousseau²

2015

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Prognostic value of PINI index in patients with multiple myeloma

Abstract: 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.

Cited by 21 publications

References 10 publications

Incident hyperglycemia, parenteral nutrition administration and adverse outcomes in patients with myeloma admitted for initial auto-SCT

Incident hyperglycemia, parenteral nutrition administration and adverse outcomes in patients with myeloma admitted for initial auto-SCT

Biomarkers in immunonutrition programme, is there still a need for new ones? A brief review

Handbook of Multiple Myeloma

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