Optimizing Autologous Stem Cell Transplantation in Multiple Myeloma: The Significance of Pre-Transplant Controlling Nutritional Status Score

Nutritional status is an important prognostic factor in patients with multiple myeloma (MM). The Controlling Nutritional Status (CONUT) score has shown promise in predicting outcomes in various malignancies; however, its role in autologous stem cell transplantation (ASCT) in patients with MM remains unclear. This study aimed to evaluate the significance of pre-transplant CONUT scores in predicting post-transplant engraftment kinetics and early complications in patients with MM undergoing ASCT. This single-center, retrospective study analyzed 59 multiple myeloma patients who underwent ASCT between 1 October 2022, and 1 July 2024. Pre-transplant CONUT scores were calculated, and their associations with various post-transplant outcomes were assessed using statistical analyses. Higher CONUT scores were independently associated with longer neutrophil engraftment times (p = 0.012). Patients who developed oral mucositis (OM) had significantly higher CONUT scores than those without OM (p = 0.028). A CONUT score cut-off of 2.5 demonstrated 100% sensitivity and 57.14% specificity in predicting OM (Area Under the Curve (AUC) 0.792, 95% CI: 0.654–0.930, p = 0.033). Our study demonstrates that a higher pre-transplant CONUT score is significantly associated with a delay in neutrophil engraftment and an increased risk of developing oral mucositis. These findings suggest that the CONUT score can serve as a valuable predictive tool for early post-transplant complications, thereby guiding targeted interventions and improving patient management.