Can low body mass index and undernutrition influence survival in patients with multiple myeloma?

This study evaluated the impact of low body mass index (BMI; a measure of weight in relation to height) and undernutrition in patients with multiple myeloma (MM). The authors concluded that being underweight, low protein level higher high lactate dehydrogenase (LDH) and light chain ratios, and poor performance status were associated with poorer outcomes.

MM is a cancer of plasma cells. Lowered serum albumin levels, known as hypoalbuminemia, commonly occurs in MM. Damaged cells also produce LDH. In patients with MM, changes in antibody light chain ratios can be observed.

Advancements in MM treatment have led to better overall patient survival. Early mortality, however, remains an issue and is often caused by infections. Patient parameters like body weight (BW) loss and BMI are easy to measure and cost-effective. BMI is a measure of the patient’s nutritional status. These parameters may provide useful indications of patient survival or poor survival outcomes.

This study investigated the impact of low BMI and undernutrition in 378 patients with newly diagnosed MM. Low BMI was defined as 18.5 kg/m² or lower. BMI, albumin levels, LDH and light chain ratios were evaluated.

7.9% of patients had low BMI. The average survival of patients with normal or high BMI was 5 years compared to 1.3 years for those with low BMI.

Other risk factors of poorer outcomes were low albumin levels, and high LDH and light chain ratios.

This study showed that being underweight was associated with poorer outcomes in patients with MM.

This study was based on medical records. Information such as genetic abnormalities was missing. This might have influenced the results. The study focused on a population from Taipei so the results may not be translated to the global population.