J Cancer 2021; 12(23):7010-7017. doi:10.7150/jca.62340 This issue

Research Paper

Prognostic values of geriatric nutritional risk index (GNRI) and prognostic nutritional index (PNI) in elderly patients with Diffuse Large B-Cell Lymphoma

Dongmei Yan1*, Ziyuan Shen2*, Shuo Zhang1*, Lingling Hu1, Qian Sun1, Kailin Xu1, Yingliang Jin3✉, Wei Sang1✉

1. Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221002, China.
2. Department of Epidemiology and Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China.
3. Center for Medical Statistics and Data Analysis, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China.
*These authors contributed equally to this work.

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Citation:
Yan D, Shen Z, Zhang S, Hu L, Sun Q, Xu K, Jin Y, Sang W. Prognostic values of geriatric nutritional risk index (GNRI) and prognostic nutritional index (PNI) in elderly patients with Diffuse Large B-Cell Lymphoma. J Cancer 2021; 12(23):7010-7017. doi:10.7150/jca.62340. Available from https://www.jcancer.org/v12p7010.htm

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Abstract

Graphic abstract

Background: Geriatric nutritional risk index (GNRI) and prognostic nutritional index (PNI) are associated with prognosis of various malignancies. Although GNRI and PNI indicates prognosis in some clinical settings, the values of GNRI and PNI on the prognosis of geriatric patients with Diffuse Large B‐Cell Lymphoma (DLBCL) is unclear. This retrospective analysis aimed to explore the prognostic values of GNRI and PNI in elderly DLBCL patients.

Methods: A total of 133 geriatric patients with DLBCL were recruited from Affiliated Hospital of Xuzhou Medical University, and clinicopathological variables were analyzed. X-Tile program, restricted cubic spline (RCS) and time-dependent receiver operating characteristic (ROC) analysis were used to determine optimal cut-off points of GNRI, PNI and other continuous variables; univariate and multivariate Cox proportional hazards analyses were used for variables selection; Kaplan‐Meier curve was utilized to analyze the influence of variables on prognosis; log-rank test was performed for difference evaluation between groups.

Results: The optimal cut-off points for GNRI and PNI were 106.26 and 47 by using RCS. Multivariate analysis showed that PNI, age, hemoglobin, liver invasion and central nervous system invasion were independent prognostic factors for elderly patients with DLBCL, and PNI was (P = 0.001, HR = 0.413, 95% CI (0.240-0.710) a stronger predictor. Low PNI could predict worse prognosis independently of elderly patients of DLBCL and could re-stratify patients in GCB group, CD5 positive group BCL-2 positive group, and BCL-6 positive group.

Conclusions: PNI was an independent adverse factor for elderly DLBCL and patients with low PNI in GCB group, CD5 positive group and BCL-6 positive group were with poor survival.

Keywords: DLBCL, GNRI, PNI, Prognosis, elderly patients