{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T01:15:19Z","timestamp":1787966119914,"version":"build-2784847793"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Prognostic nutritional index (PNI) has been extensively investigated for its effect on forecasting multiple myeloma (MM) survival; however, the conclusions are conflicting. This meta-analysis identified an accurate MM prognosis forecasting role for the PNI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We systematically searched PubMed, Web of Science, Embase, Cochrane Library, and CNKI databases until July 2, 2025, and evaluated the overall survival (OS) and progression-free survival (PFS) forecasting ability of the PNI by determining pooled hazard ratios (HRs) with 95% confidence intervals (CIs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study included seven articles involving 1120 participants. From the pooled findings, a lower PNI exhibited a remarkable correlation with unfavorable OS (HR = 2.62, 95% CI = 1.76\u20133.89) and shorter PFS (HR = 1.52, 95% CI = 1.23\u20131.89, p&amp;lt;0.001) of MM. Additionally, lower PNI was significantly associated with ISS stage III (odds ratio [OR]=1.80, 95% CI = 1.19\u20132.73, p=0.005). However, PNI did not have a marked correlation with sex (OR = 1.02, 95% CI = 0.71\u20131.47, p=0.900), age (OR = 1.1, 95% CI = 0.70\u20131.93, p=0.558), and lactate dehydrogenase (OR = 0.98, 95% CI = 0.57\u20131.69, p=0.955) in MM. The meta-analysis had some limitations, such as retrospective design, small sample size, and inconsistent cut-off values of PNI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Collectively, the present work including 1120 patients showed the relationship between a lower PNI and unfavorable MM OS and PFS. Furthermore, a lower PNI was significantly associated with an advanced ISS stage of MM. The PNI can be a creditable and cost-effective factor for forecasting MM prognosis.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2025.1545096","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T04:13:13Z","timestamp":1758255193000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Prognostic and clinicopathological value of prognostic nutritional index in patients with multiple myeloma: a 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