Geriatric nutritional risk index as a prognostic factor in patients with diffuse large B cell lymphoma

2018 ◽  
Vol 97 (6) ◽  
pp. 999-1007 ◽  
Author(s):  
Yusuke Kanemasa ◽  
Tatsu Shimoyama ◽  
Yuki Sasaki ◽  
Tsunekazu Hishima ◽  
Yasushi Omuro
Keyword(s):  
Prognostic Factor ◽  
B Cell ◽  
Cell Lymphoma ◽  
Risk Index ◽  
B Cell Lymphoma ◽  
Nutritional Risk ◽  
Geriatric Nutritional Risk Index ◽  
Large B Cell Lymphoma ◽  
Nutritional Risk Index ◽  
Large B Cell

scholarly journals Prognostic model based on the Geriatric Nutritional Risk Index and sarcopenia in patients with diffuse large B-cell lymphoma

2020 ◽  
Author(s):  
Se-Il Go ◽  
Hoon-Gu Kim ◽  
Myoung Hee Kang ◽  
Sungwoo Park ◽  
Gyeong-Won Lee
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Risk Index ◽  
B Cell Lymphoma ◽  
Nutritional Risk ◽  
Geriatric Nutritional Risk Index ◽  
Skeletal Muscle Index ◽  
Large B Cell Lymphoma ◽  
Nutritional Risk Index ◽  
Large B Cell

Abstract Background: Systemic inflammation and cachexia are associated with adverse clinical outcomes in diffuse large B-cell lymphoma (DLBCL). The Geriatric Nutritional Risk Index (GNRI) is one of the main parameters used to assess these conditions, but its efficacy in DLBCL is inconclusive.Methods: We retrospectively reviewed 228 DLBCL patients who were treated with R-CHOP immunochemotherapy (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone). The patients were stratified according to GNRI score (> 98, 92 to 98, 82 to < 92, and < 82) as defined in previous studies. Additionally, the extent of sarcopenia was categorized as sarcopenia-both, sarcopenia-L3/PM alone, and non-sarcopenia-both according to skeletal muscle index.Results: Survival curves plotted against a combination of GNRI and sarcopenia scores revealed two clear groups as follows: high cachexia risk (HCR) group (GNRI < 82, sarcopenia-both, or GNRI 82-92 with sarcopenia-L3/PM alone) and low cachexia risk (LCR) group (others). The HCR group had a lower complete response rate (46.5% vs. 86.6%) and higher frequency of treatment-related mortality (19.7% vs. 3.8%) and early treatment discontinuation (43.7% vs. 8.3%) compared with the LCR group. The median progression-free survival (PFS) (not reached vs. 10.3 months, p < 0.001) and overall survival (OS) (not reached vs. 12.9 months, p < 0.001) were much shorter in the HCR group than in the LCR group. On multivariable analyses, the HCR group was shown to be an independent negative prognostic factor for PFS and OS after adjusting the National Comprehensive Cancer Network-International Prognostic Index (NCCN-IPI).Conclusions: A combined model of GNRI and sarcopenia may provide prognostic information independently of the NCCN-IPI in DLBCL.

scholarly journals Prognostic model based on the Geriatric Nutritional Risk Index and sarcopenia in patients with diffuse large B-cell lymphoma

2020 ◽  
Author(s):  
Se-Il Go ◽  
Hoon-Gu Kim ◽  
Myoung Hee Kang ◽  
Sungwoo Park ◽  
Gyeong-Won Lee
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Risk Index ◽  
B Cell Lymphoma ◽  
Nutritional Risk ◽  
Geriatric Nutritional Risk Index ◽  
Skeletal Muscle Index ◽  
Large B Cell Lymphoma ◽  
Nutritional Risk Index ◽  
Large B Cell

Abstract Background Systemic inflammation and cachexia are associated with adverse clinical outcomes in diffuse large B-cell lymphoma (DLBCL). The Geriatric Nutritional Risk Index (GNRI) is one of the main parameters used to assess these conditions, but its efficacy in DLBCL is inconclusive. Methods We retrospectively reviewed 228 DLBCL patients who were treated with R-CHOP immunochemotherapy (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone). The patients were stratified according to GNRI score (> 98, 92 to 98, 82 to < 92, and < 82) as defined in previous studies. Additionally, the extent of sarcopenia was categorized as sarcopenia-both, sarcopenia-L3/PM alone, and non-sarcopenia-both according to skeletal muscle index. Results Survival curves plotted against a combination of GNRI and sarcopenia scores revealed two clear groups as follows: high cachexia risk (HCR) group (GNRI < 82, sarcopenia-both, or GNRI 82-92 with sarcopenia-L3/PM alone) and low cachexia risk (LCR) group (others). The HCR group had a lower complete response rate (46.5% vs. 86.6%) and higher frequency of treatment-related mortality (19.7% vs. 3.8%) and early treatment discontinuation (43.7% vs. 8.3%) compared with the LCR group. The median progression-free survival (PFS) (not reached vs. 10.3 months, p < 0.001) and overall survival (OS) (not reached vs. 12.9 months, p < 0.001) were much shorter in the HCR group than in the LCR group. On multivariable analyses, the HCR group was shown to be an independent negative prognostic factor for PFS and OS after adjusting the National Comprehensive Cancer Network-International Prognostic Index (NCCN-IPI). Conclusions A combined model of GNRI and sarcopenia may provide prognostic information independently of the NCCN-IPI in DLBCL.

scholarly journals Low Geriatric Nutritional Risk Index Is Associated with Poorer Prognosis in Elderly Diffuse Large B-cell Lymphoma Patients Unfit for Intensive Anthracycline-Containing Therapy: A Real-World Study

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3243
Author(s):  
Tzer-Ming Chuang ◽  
Yi-Chang Liu ◽  
Hui-Hua Hsiao ◽  
Hui-Ching Wang ◽  
Jeng-Shiun Du ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Risk Index ◽  
B Cell Lymphoma ◽  
Nutritional Risk ◽  
Geriatric Nutritional Risk Index ◽  
Predictive Tool ◽  
Large B Cell Lymphoma ◽  
Nutritional Risk Index ◽  
Large B Cell

Nutritional assessments, including the Geriatric Nutritional Risk Index (GNRI), have emerged as prediction tools for long-term survival in various cancers. This study aimed to investigate the therapeutic strategy and explore the prognostic factors in the elderly patients (≥ 65 years) with diffuse large B cell lymphoma (DLBCL). The cutoff value of the GNRI score (92.5) was obtained using the receiver operating characteristic curve. Among these patients (n = 205), 129 (62.9%) did not receive standard R–CHOP chemotherapy. Old age (≥80 years), poor performance status, low serum albumin level, and comorbidities were the major factors associated with less intensive anti-lymphoma treatment. Further analysis demonstrated that a lower GNRI score (<92.5) was linked to more unfavorable clinical features. In the patients who received non-anthracycline-containing regimens (non-R–CHOP), multivariate analysis showed that a low GNRI can serve as an independent predictive factor for worse progression-free (HR, 2.85; 95% CI, 1.05–7.72; p = 0.039) and overall survival (HR, 2.98; 95% CI, 1.02–8.90; p = 0.045). In summary, nutritional evaluation plays a role in DLBCL treatment and the GNRI score can serve as a feasible predictive tool for clinical outcomes in frail elderly DLBCL patients treated with non-anthracycline-containing regimens.

18F-FDG cerebellum/liver index as a prognostic factor for progression-free survival in diffuse large B-cell lymphoma

2021 ◽  
Author(s):  
David Morland ◽  
Ghali Zizi ◽  
François Godard ◽  
Anne-Cécile Gauchy ◽  
Carole Durot ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
B Cell ◽  
Cell Lymphoma ◽  
Progression Free Survival ◽  
B Cell Lymphoma ◽  
Free Survival ◽  
Liver Index ◽  
Large B Cell Lymphoma ◽  
18F Fdg ◽  
Large B Cell

scholarly journals Consecutive Hypoalbuminemia Predicts Inferior Outcome in Patients With Diffuse Large B-Cell Lymphoma

2021 ◽  
Vol 10 ◽  
Author(s):  
Xiaolei Wei ◽  
Jingxia Zheng ◽  
Zewen Zhang ◽  
Qiongzhi Liu ◽  
Minglang Zhan ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Serum Albumin ◽  
B Cell ◽  
Validation Cohort ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Training Cohort ◽  
Large B Cell Lymphoma ◽  
Large B Cell ◽  
Low Serum

The prognostic value of albumin changes between diagnosis and end-of-treatment (EoT) in diffuse large B-cell lymphoma (DLBCL) remains unknown. We retrospectively analyzed 574 de novo DLBCL patients treated with R-CHOP from our and two other centers. All patients were divided into a training cohort (n = 278) and validation cohort (n = 296) depending on the source of the patients. Overall survival (OS) and progression-free survival (PFS) were analyzed by the method of Kaplan–Meier and Cox proportional hazard regression model. In the training cohort, 163 (58.6%) patients had low serum albumin at diagnosis, and 80 of them were present with consecutive hypoalbuminemia at EoT. Patients with consecutive hypoalbuminemia showed inferior OS and PFS (p = 0.010 and p = 0.079, respectively). Similar survival differences were also observed in the independent validation cohort (p = 0.006 and p = 0.030, respectively). Multivariable analysis revealed that consecutive hypoalbuminemia was an independent prognostic factor OS [relative risk (RR), 2.249; 95% confidence interval (CI), 1.441–3.509, p &lt; 0.001] and PFS (RR, 2.001; 95% CI, 1.443–2.773, p &lt; 0.001) in all DLBCL patients independent of IPI. In conclusion, consecutive hypoalbuminemia is a simple and effective adverse prognostic factor in patients with DLBCL, which reminds us to pay more attention to patients with low serum albumin at EoT during follow-up.

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