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Yu Q, Tian M, Pi G, Jia Y, Jin X. Geriatric nutritional risk index as a predictor of prognosis in hematologic malignancies: a systematic review and meta-analysis. Front Nutr 2023; 10:1274592. [PMID: 37941772 PMCID: PMC10627839 DOI: 10.3389/fnut.2023.1274592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 09/29/2023] [Indexed: 11/10/2023] Open
Abstract
Objective Recent studies have reported inconsistent results regarding the association between geriatric nutritional risk index (GNRI) and clinical outcomes in patients with hematologic malignancies (HMs). We performed a meta-analysis to evaluate the effect of low GNRI on the overall survival (OS) and progression-free survival (PFS) in patients with HMs. Research Methods and Procedures We conducted the research via PubMed, Embase, and Cochrane Library databases to identify trials. Exploring the association between GNRI and prognosis in patients with HMs. A meta-analysis of OS and PFS was performed. Quality In Prognostic Studies instrument and Newcastle-Ottawa quality assessment Scale were used to assess the quality of included trials. Results Fourteen studies enrolling 3,524 patients with HMs were included. Low GNRI was associated with shorter OS (Hazard ratio (HR) = 1.77; 95% CI = 1.44-2.18, p < 0.01) and PFS (HR = 1.63; 95% CI = 1.17-2.27, p < 0.01) in patients with HMs. In the subgroup analysis, GNRI was not significantly associated with prognosis in Chinese patients with HMs (OS, HR =1.33; 95% CI = 0.89-1.98, p = 0.16; PFS, HR = 1.70; 95% CI = 0.72-4.01, p = 0.23). For the subgroup with a GNRI cutoff value less than 98, there was no significant difference in PFS (HR = 1.34; 95% CI = 0.98-1.83, p = 0.06). Conclusion Low GNRI negatively impacted on the prognosis in patients with HMs. Prospective studies to identify the best cut-off value for GNRI are required.
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Affiliation(s)
- Qiong Yu
- Department of Digestive Medicine, Wuhan Sixth Hospital and Affiliated Hospital of Jianghan University, Wuhan, China
| | - Mengxing Tian
- Department of Clinical Nutrition, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guoliang Pi
- Department of Thoracic Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yegui Jia
- Department of Digestive Medicine, Wuhan Sixth Hospital and Affiliated Hospital of Jianghan University, Wuhan, China
| | - Xin Jin
- Department of Clinical Nutrition, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Lee S, Fujita K, Morishita T, Negoro E, Tsukasaki H, Oiwa K, Hara T, Tsurumi H, Ueda T, Yamauchi T. The Relative Dose Intensity Changes during Cycles of Standard Regimens in Patients with Diffuse Large B-Cell Lymphoma. Cancers (Basel) 2023; 15:4458. [PMID: 37760427 PMCID: PMC10526837 DOI: 10.3390/cancers15184458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/01/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
No studies have focused on the trajectory of the average relative dose intensity (ARDI) during cycles of first-line chemotherapy for patients with diffuse large B-cell lymphoma. To evaluate the impact of attenuating ARDI during cycles on overall survival, we conducted a multi-centre, longitudinal, observational retrospective study. A total of 307 analysable patients were enrolled. Multivariate Cox hazards modelling with restricted cubic spline models revealed prognostic benefits of higher ARDI up to, but not after, cycle 6. According to group-based trajectory modelling, patients were classified into five groups depending on the pattern of ARDI changes. Among these, two groups in which ARDI had fallen significantly to less than 50% by cycles 4-6 displayed significantly poorer prognosis, despite increased ARDI in the second half of the treatment period (log-rank p = 0.02). The Geriatric Nutritional Risk Index offered significant prediction of unfavourable ARDI changes (odds ratio 2.540, 95% confidence interval 1.020-6.310; p = 0.044). Up to cycle 6, maintenance of ARDI in all cycles (but particularly in the early cycles) is important for prognosis. Malnutrition is a significant factor that lets patients trace patterns of ARDI changes during cycles of chemotherapy associated with untoward prognosis.
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Affiliation(s)
- Shin Lee
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan; (S.L.); (K.F.)
- Department of Hematology and Oncology, Matsunami General Hospital, Gifu 501-6062, Japan
| | - Kei Fujita
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan; (S.L.); (K.F.)
- Department of Hematology and Oncology, Matsunami General Hospital, Gifu 501-6062, Japan
| | - Tetsuji Morishita
- Department of Internal Medicine, Matsunami General Hospital, Gifu 501-6062, Japan;
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan
| | - Eiju Negoro
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan; (S.L.); (K.F.)
- Department of Cancer Care Promotion Center, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan
| | - Hikaru Tsukasaki
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan; (S.L.); (K.F.)
- Department of Hematology, Fukui Red Cross Hospital, Fukui 918-8501, Japan
| | - Kana Oiwa
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan; (S.L.); (K.F.)
- Department of Internal Medicine, Osu Hospital, Nagoya 460-0017, Japan
| | - Takeshi Hara
- Department of Hematology and Oncology, Matsunami General Hospital, Gifu 501-6062, Japan
| | - Hisashi Tsurumi
- Department of Hematology and Oncology, Matsunami General Hospital, Gifu 501-6062, Japan
| | - Takanori Ueda
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan; (S.L.); (K.F.)
| | - Takahiro Yamauchi
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan; (S.L.); (K.F.)
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de Jonge AV, van Werkhoven E, Dinmohamed AG, Nijland M, Zwinderman AH, Bossuyt PM, Veldhuis MS, Rutten EGGM, Mous R, Vermaat JSP, Sandberg Y, de Jongh E, Bilgin YM, Boersma R, Koene H, Kersten MJ, de Jong D, Chamuleau MED. A non-randomized risk-adjusted comparison of lenalidomide + R-CHOP versus R-CHOP for MYC-rearranged DLBCL patients. Blood Cancer J 2023; 13:85. [PMID: 37217463 PMCID: PMC10203347 DOI: 10.1038/s41408-023-00854-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/25/2023] [Accepted: 05/03/2023] [Indexed: 05/24/2023] Open
Abstract
Patients with MYC rearranged (MYC-R) diffuse large B-cell lymphoma (DLBCL) have a poor prognosis. Previously, we demonstrated in a single-arm phase II trial (HOVON-130) that addition of lenalidomide to R-CHOP (R2CHOP) is well-tolerated and yields similar complete metabolic remission rates as more intensive chemotherapy regimens in literature. In parallel with this single-arm interventional trial, a prospective observational screening cohort (HOVON-900) was open in which we identified all newly diagnosed MYC-R DLBCL patients in the Netherlands. Eligible patients from the observational cohort that were not included in the interventional trial served as control group in the present risk-adjusted comparison. R2CHOP treated patients from the interventional trial (n = 77) were younger than patients in the R-CHOP control cohort (n = 56) (median age 63 versus 70 years, p = 0.018) and they were more likely to have a lower WHO performance score (p = 0.013). We adjusted for differences at baseline using 1:1 matching, multivariable analysis, and weighting using the propensity score to reduce treatment-selection bias. These analyses consistently showed improved outcome after R2CHOP with HRs of 0.53, 0.51, and 0.59, respectively, for OS, and 0.53, 0.59, and 0.60 for PFS. Thus, this non-randomized risk-adjusted comparison supports R2CHOP as an additional treatment option for MYC-R DLBCL patients.
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Grants
- Genmab (consultancy), Takeda (research funding), Roche (research funding)
- BMS/Celgene, Kite, Roche (honoraria and research funding) Miltenyi Biotech, Novartis, Takeda, Adicet Bio (honoraria)
- KWF Kankerbestrijding (Dutch Cancer Society)
- BMS/Celgene (Honoraria and research funding), Gilead and Genmab (research funding), Roche, Abbvie, Novartis (honoraria)
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Affiliation(s)
- A Vera de Jonge
- Department of Hematology, Amsterdam UMC location VU, Amsterdam, The Netherlands.
| | - Erik van Werkhoven
- HOVON Data Center, Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Avinash G Dinmohamed
- Department of Hematology, Amsterdam UMC location VU, Amsterdam, The Netherlands
- Erasmus MC, Department of Public Health, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Marcel Nijland
- Department of Hematology, University Medical Center Groningen, Groningen, The Netherlands
| | - Aeilko H Zwinderman
- Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Patrick M Bossuyt
- Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Martine S Veldhuis
- Department of Hematology, Amsterdam UMC location VU, Amsterdam, The Netherlands
| | - Emma G G M Rutten
- Department of Pathology, Amsterdam UMC location VU, Amsterdam, The Netherlands
| | - Rogier Mous
- Department of Hematology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Joost S P Vermaat
- Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
| | - Yorick Sandberg
- Department of Internal Medicine, Maasstad Hospital, Rotterdam, The Netherlands
| | - Eva de Jongh
- Department of Hematology, Albert Schweitzer Ziekenhuis, Dordrecht, The Netherlands
| | - Yavuz M Bilgin
- Department of Internal Medicine, Adrz, Goes, The Netherlands
| | - Rinske Boersma
- Department of Internal Medicine, Amphia Ziekenhuis, Breda, The Netherlands
| | - Harry Koene
- Department of Hematology, St Antonius Ziekenhuis, Nieuwegein, The Netherlands
| | - Marie José Kersten
- Department of Hematology, Amsterdam UMC location VU, Amsterdam, The Netherlands
| | - Daphne de Jong
- Department of Pathology, Amsterdam UMC location VU, Amsterdam, The Netherlands
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Zhang Z, Tang Y, Pan H, Yao C, Zhang T. Assessment of the Ecological Protection Effectiveness of Protected Areas Using Propensity Score Matching: A Case Study in Sichuan, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084920. [PMID: 35457788 PMCID: PMC9033088 DOI: 10.3390/ijerph19084920] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/08/2022] [Accepted: 04/16/2022] [Indexed: 02/04/2023]
Abstract
Protected areas constitute a global strategic resource for enhancing the effectiveness of ecological protection, which can alleviate the impact of unsustainable human production and living activities on the ecological environment. However, the spatiotemporal evolution of ecological protection effectiveness needs to be quantitatively revealed. The net primary productivity (NPP) of plants is an important measure of the effectiveness of ecological protection efforts. The main purpose of this study is to use the relative change in the annual average NPP to evaluate the ecological protection effectiveness of protected areas. We compared the historical changes in the annual average NPP of protected areas in Sichuan Province from 2000 to 2019. We added the spatial coordinates to the impact factor system and adopted propensity score matching (PSM) in a quasi-natural experimental method to determine the experimental group and the control group. The ecological protection effectiveness of the protected areas in the study area in 2000, 2005, 2010, 2015, and 2019 was measured and classified into three types of changes in protection effectiveness, namely effective, ineffective, or fluctuating. According to the administrative level, type, and spatial distribution, we determined the number and type of changes in the protection effectiveness of different protected areas. The results show that the annual average NPP of the protected areas in Sichuan Province generally fluctuated. The annual average NPP increased in 95.47% of the total protected area and decreased in 4.53%. The overall protection effectiveness of protected areas was positive and significant and gradually improved. Effective protected areas at the national, provincial, and county levels accounted for 40.27% of the total number of protected areas, and the other 14.77% of effective protected area was managed at other administrative levels. Among the different types of protected areas, the proportion of effective protected areas was highest in wild animal protected areas, followed by forest ecology protected areas, wild plant protected areas, and wetland ecology protected areas. The results of this study can provide an important reference for the verification and improvement of the ecological protection effectiveness of various protected areas.
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Affiliation(s)
- Zhifeng Zhang
- Key Laboratory of Land Resources Evaluation and Monitoring in Southwest, Ministry of Education, Chengdu 610068, China; (Z.Z.); (Y.T.); (C.Y.); (T.Z.)
- The Faculty of Geography and Resources Sciences, Sichuan Normal University, Chengdu 610068, China
| | - Yuping Tang
- Key Laboratory of Land Resources Evaluation and Monitoring in Southwest, Ministry of Education, Chengdu 610068, China; (Z.Z.); (Y.T.); (C.Y.); (T.Z.)
- The Faculty of Geography and Resources Sciences, Sichuan Normal University, Chengdu 610068, China
| | - Hongyi Pan
- Key Laboratory of Land Resources Evaluation and Monitoring in Southwest, Ministry of Education, Chengdu 610068, China; (Z.Z.); (Y.T.); (C.Y.); (T.Z.)
- The Faculty of Geography and Resources Sciences, Sichuan Normal University, Chengdu 610068, China
- Correspondence: ; Tel.: +86-139-8209-1935
| | - Caiyi Yao
- Key Laboratory of Land Resources Evaluation and Monitoring in Southwest, Ministry of Education, Chengdu 610068, China; (Z.Z.); (Y.T.); (C.Y.); (T.Z.)
- The Faculty of Geography and Resources Sciences, Sichuan Normal University, Chengdu 610068, China
| | - Tianyi Zhang
- Key Laboratory of Land Resources Evaluation and Monitoring in Southwest, Ministry of Education, Chengdu 610068, China; (Z.Z.); (Y.T.); (C.Y.); (T.Z.)
- The Faculty of Geography and Resources Sciences, Sichuan Normal University, Chengdu 610068, China
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