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Atas U, Sozel H, Iltar U, Yucel OK, Salim O, Undar L. The Prognostic Impact of Pretreatment Geriatric Nutritional Risk Index in Patients with Diffuse Large B-Cell Lymphoma. Nutr Cancer 2023; 75:591-598. [PMID: 36343361 DOI: 10.1080/01635581.2022.2142248] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The prognostic value of the geriatric nutritional risk index (GNRI) is not clear in patients with diffuse large B-cell lymphoma (DLBCL). This study was designed to analyze the GNRI in DLBCL patients and to investigate its prognostic value in DLBCL. The archive records of DLBCL patients between 2008 and 2020 at the Akdeniz University Hospital were retrospectively analyzed. A total of 206 patients with DLBCL were recruited and classified into two GNRI-based groups based on nutrition status. The GNRI cut off value was determined by ROC analysis. In the univariate Cox regression analysis for overall survival (OS), age, lactate dehydrogenase, B symptoms, infiltration of bone marrow, and the GNRI were determined as prognostic factors for mortality. The OS of patients with a GNRI ≤104.238 was significantly lower than that of patients with a GNRI >104.238 (p = 0.001). The progression-free survival (PFS) of patients with GNRI ≤104.238 was significantly lower compared to the patients with GNRI >104.238 (p = 0.010). Based on the results of the present study with a relatively large hospital-based cohort, the GNRI can be recommended for use as an independent prognostic marker for OS and PFS in patients with DLBCL.
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Affiliation(s)
- Unal Atas
- Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Akdeniz University, Antalya, Turkey
| | - Hasan Sozel
- Faculty of Medicine, Department of Internal Medicine, Akdeniz University, Antalya, Turkey
| | - Utku Iltar
- Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Akdeniz University, Antalya, Turkey
| | - Orhan Kemal Yucel
- Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Akdeniz University, Antalya, Turkey
| | - Ozan Salim
- Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Akdeniz University, Antalya, Turkey
| | - Levent Undar
- Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Akdeniz University, Antalya, Turkey
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Lee S, Fujita K, Morishita T, Negoro E, Oiwa K, Tsukasaki H, Yamamura O, Ueda T, Yamauchi T. Prognostic utility of a geriatric nutritional risk index in combination with a comorbidity index in elderly patients with diffuse large B cell lymphoma. Br J Haematol 2020; 192:100-109. [PMID: 32410224 DOI: 10.1111/bjh.16743] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 04/21/2020] [Indexed: 12/18/2022]
Abstract
Reflecting the increasing risk in elderly patients with diffuse large B cell lymphoma (DLBCL), prognostic predictors other than the International Prognostic Index have attracted more attention. This study presents the first analysis of the prognostic utility of the Geriatric Nutritional Risk Index (GNRI) in combination with the Charlson Comorbidity Index (CCI) for overall survival (OS) in elderly DLBCL patients. A multicentre retrospective was conducted on a cohort of 451 patients (≥65 years). The GNRI and CCI were independent predictors in a multivariate Cox proportional hazard model. There was a nonlinear correlation between the GNRI and OS in a Cox model with restricted cubic spline. Multivariate receiver operating characteristic curves showed a significant improvement in prediction accuracy when the GNRI was added to CCI. Adding the GNRI to CCI yielded a significant category-free net reclassification improvement (0·556; 95% CI: 0·378-0·736, P < 0·001) and integrated discrimination improvement (0·094; 95% CI: 0·067-0·122, P < 0·001). The decision curve analysis demonstrated the clinical net benefit associated with the adoption of the GNRI. The GNRI was not only a predictor of OS but also remarkably improved the prognosis prediction accuracy when incorporated with the CCI, having the ability to stratify the prognosis of elderly DLBCL patients.
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Affiliation(s)
- Shin Lee
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.,Department of Hematology, Matsunami General Hospital, Gifu, Japan
| | - Kei Fujita
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.,Department of Hematology, Matsunami General Hospital, Gifu, Japan
| | - Tetsuji Morishita
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.,Department of Cardiovascular Medicine, National Hospital Organization Awara Hospital, Fukui, Japan
| | - Eiju Negoro
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kana Oiwa
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.,Department of Hematology and Oncology, Nagoya City University, Aichi, Japan
| | - Hikaru Tsukasaki
- Department of Hematology, Fukui Red Cross Hospital, Fukui, Japan
| | - Osamu Yamamura
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Takanori Ueda
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Takahiro Yamauchi
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
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Lee S, Fujita K, Negoro E, Morishita T, Oiwa K, Tsukasaki H, Kinoshita K, Kawai Y, Ueda T, Yamauchi T. Impact of relative dose intensity of standard regimens on survival in elderly patients aged 80 years and older with diffuse large B-cell lymphoma. Haematologica 2020; 105:e415-e418. [PMID: 31919079 DOI: 10.3324/haematol.2019.234435] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Shin Lee
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui.,Department of Cancer Care Promotion Centre, Faculty of Medical Sciences, University of Fukui
| | - Kei Fujita
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui
| | - Eiju Negoro
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui .,Department of Cancer Care Promotion Centre, Faculty of Medical Sciences, University of Fukui
| | - Tetsuji Morishita
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui.,Department Cardiovascular Medicine, National Hospital Organization Awara Hospital
| | - Kana Oiwa
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui
| | | | | | - Yasukazu Kawai
- Department of Hematology and Oncology, Fukui Prefectural Hospital, Fukui, Japan
| | - Takanori Ueda
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui
| | - Takahiro Yamauchi
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui
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