Geriatric Nutritional Risk Index and autologous stem cell transplantation predicted 10-year survival time in multiple myeloma

Background: Multiple myeloma (MM) remains incurable, although a subset of patients achieves survival ≥10 years. Identifying predictors of extended survival is critical for risk stratification and individualized treatment. Methods: We retrospectively analyzed 184 patients newly diagnosed with MM aged <80 years between 2009 and 2014. The primary endpoint was overall survival (OS) ≥10 years; the secondary endpoint was time to next treatment ≥10 years. Prognostic factors, including the Geriatric Nutritional Risk Index (GNRI), were assessed using multivariate logistic regression. Results: Long-term survival and durable treatment response were observed in 25.0% and 8.7% of patients, respectively. In multivariate analysis, GNRI >92 was an independent predictor of long-term survival (odds ratio [OR], 2.940; 95% confidence interval [CI], 1.130–7.610; P = 0.027). Autologous stem cell transplantation (ASCT) was significantly associated with long-term treatment response (OR, 5.070; 95%CI, 1.680–a20.30; P = 0.006). GNRI >92 correlated with favorable disease characteristics (e.g., ISS stage I, normal C-reactiveprotein) but was independent of treatment intensity. Among long-term survivors, GNRI did not affect OS beyond 10 years. Conclusions: Baseline GNRI >92 and ASCT were independent predictors of long-term survival and durable treatment response, respectively. These findings highlight the prognostic significance of host nutritional status and support the continued role of ASCT in eligible patients. Incorporating GNRI into routine evaluation may improve individualized management strategies for MM.