Background: Several thrombotic risk assessment models have been proposed for identifying patients with a high risk of thrombosis (the IMPEDE venous thromboembolism (VTE), SAVED, and PRISM scores) in multiple myeloma (MM). Recently, adding a biomarker (D-dimer) for the IMPEDE VTE score has shown that it can boost the detection power of IMPEDED VTE. However, data from studies comparing these models in MM are scarce. Even real-world data arguing the utility of thrombotic risk assessment models in MM from low- or middle-income countries like Türkiye are lacking. Methods: We aimed to show the possibility of detecting VTE using the IMPEDED VTE score in our cohort by retrospectively screening MM patients. Therefore, we aimed to compare the IMPEDE VTE, SAVED and IMPEDED VTE scoring models. Results: We conducted a retrospective analysis of 455 MM patients from three centers in Bursa, Türkiye, evaluating the incidence of VTE within six months of the treatment. The IMPEDED VTE score showed superior predictive accuracy (c-statistic of 0.701), compared to the IMPEDE VTE (0.618) and SAVED (0.633) scores, demonstrating the added value of D-dimer as a biomarker. The cumulative incidence of VTE in the cohort was 10.7%, comparable to rates observed in real-world studies. Conclusions: Despite the interventions and thrombotic risk assessment models, thrombosis remains a high-risk entity. Personalized risk assessment tools, such as IMPEDED VTE, could be used to manage thrombotic risk in MM patients, particularly in resource-limited settings. Albeit the thromboprophylaxis (51.6%), our findings support the utility of biomarker-enhanced models for better VTE-risk stratification, particularly in resource-limited settings.

Background/Objectives: The modified Endothelial Activation and Stress Index (mEASIX), derived from routinely available laboratory parameters, has emerged as a potential biomarker reflecting systemic inflammatory and endothelial stress. However, its prognostic value in myelodysplastic syndromes (MDS) remains incompletely defined. This study evaluated the association between the mEASIX and overall survival and explored its time-dependent prognostic pattern. Methods: This retrospective study included 151 patients with MDS. The mEASIX score was calculated using C-reactive protein, lactate dehydrogenase, and platelet count and was log-transformed for regression analyses. Overall survival was estimated using the Kaplan–Meier method. Univariable and multivariable Cox proportional hazards models were used to evaluate prognostic factors, including age, IPSS-R risk group, hypomethylating agent (HMA) exposure, and venetoclax exposure. The proportional hazards assumption was assessed, and landmark analyses were performed at the median follow-up time (29 months). Receiver operating characteristic analysis was used to determine the optimal mEASIX cut-off value for mortality prediction. Model comparison, internal validation, and sensitivity analyses were also performed. Results: During a median follow-up of 29 months, 85 deaths occurred. The mEASIX yielded an AUC of 0.767 for mortality prediction (95% CI 0.691–0.844; p < 0.001). Patients with a high mEASIX had inferior overall survival (log-rank p < 0.001). In multivariable Cox regression analysis including age, IPSS-R risk group, HMA exposure, and venetoclax exposure, log(mEASIX) remained independently associated with inferior overall survival (HR 1.325, 95% CI 1.166–1.506; p < 0.001). In landmark analyses, this association persisted during the early follow-up period (≤29 months; HR 1.347, 95% CI 1.172–1.548; p < 0.001) but was attenuated during the late period (>29 months; HR 1.287, 95% CI 0.930–1.782; p = 0.128). Conclusions: The baseline mEASIX was independently associated with overall survival in patients with MDS and appeared most prognostically relevant during early follow-up. These findings suggest that the mEASIX may complement established risk models, although further validation is needed before broader clinical use.

Objective: The hemoglobin–albumin–lymphocyte–platelet (HALP) score reflects nutritional-inflammatory status and is a prognostic marker in several malignancies. Its potential association with renal recovery in newly diagnosed multiple myeloma (MM) remains unclear. We investigated the relationship between baseline HALP score and renal recovery in patients with newly diagnosed MM. Methods: We retrospectively evaluated 133 consecutive patients with newly diagnosed MM. Renal response analyses were restricted to 56 patients meeting prespecified baseline eGFR criteria. Renal recovery was defined by modified International Myeloma Working Group (IMWG) criteria using the last available follow-up eGFR. The median follow-up was 15 months (interquartile range [IQR], 6.5-20.75). The HALP score was evaluated using group comparisons, receiver operating characteristic (ROC), correlation, and logistic regression analyses. Results: In the renal outcome cohort (n = 56), 37 (66.1%) achieved renal recovery and 19 (33.9%) experienced nonrecovery. The median HALP score did not differ significantly between the recovery and nonrecovery groups (27.66 [IQR, 20.85–45.95] vs 22.82 [IQR, 9.90–54.94]; P = .364). HALP score discrimination for renal recovery was limited (area under the curve [AUC], 0.575; 95% CI, 0.435–0.706; P = .422). An exploratory cutoff of >18.91 yielded a sensitivity of 81.1% and specificity of 47.4%. HALP ≥18.91 was not significantly associated with renal recovery in univariable analysis (odds ratio [OR], 3.12; 95% CI, 0.91–10.64; P = .069) but showed a significant association after multivariable adjustment (OR, 4.32; 95% CI, 1.13–16.58; P = .033). The HALP score did not correlate with ΔeGFR (r = −0.058; P = .671). Conclusions: The continuous HALP score showed limited discrimination for renal recovery. However, an exploratory threshold of ≥18.91 was associated with recovery after multivariable adjustment. Given the modest sample size, wide CI, and nonsignificant ROC analysis, this threshold-based finding requires confirmation in larger independent cohorts.