Prognostic Nutritional Index Predicts Early Mortality in Diffuse Large B-cell Lymphoma
Objective: The international prognostic index (IPI) and the revised IPI (R-IPI) are used to determine the prognosis in diffuse large B-cell lymphoma (DLBCL). However, these scoring systems are insufficient to identify very high-risk patients. Recently, the prognostic nutritional index (PNI) -calcula...
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Galenos Publishing House
2022-03-01
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| Series: | Medeniyet Medical Journal |
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| Online Access: | https://jag.journalagent.com/z4/download_fulltext.asp?pdir=medeniyet&un=MEDJ-87422 |
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| author | Erman OZTURK Tayfun ELIBOL Emrah KILICASLAN Beyza KABAYUKA Işıl ERDOGAN OZUNAL |
| author_facet | Erman OZTURK Tayfun ELIBOL Emrah KILICASLAN Beyza KABAYUKA Işıl ERDOGAN OZUNAL |
| author_sort | Erman OZTURK |
| collection | DOAJ |
| description | Objective: The international prognostic index (IPI) and the revised IPI (R-IPI) are used to determine the prognosis in diffuse large B-cell lymphoma (DLBCL). However, these scoring systems are insufficient to identify very high-risk patients. Recently, the prognostic nutritional index (PNI) -calculated with lymphocyte count and albumin- has been used to determine the prognosis in DLBCL. This study aimed to evaluate the effect of PNI score on prognosis and survival in patients with high-risk DLBCL.
Methods: Patients diagnosed with DLBCL and treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone were included. Pre-treatment IPI, R-IPI, and PNI scores and progression-free survival (PFS) and overall survival (OS) times were calculated. The cut-off value for PNI according to OS was determined by using the X-Tile program.
Results: One hundred and ten patients were included, the median age was 63 years and the median follow-up period was 25 months. According to R-IPI, the me-dian OS could not be reached for the very good risk group, and the median OS values were 83 and 17 months in the good and poor-risk groups, respectively (p=0.001). The cohort was divided into three groups according to the cut-off value for the PNI: patients with PNI <33 were classified as high-risk, 33-42 intermediate-risk, and ≥42 as low-risk. According to PNI, the median durations of PFS and OS were 2 months and 3 months in the high-risk group, 9 months and 19 months in the inter-mediate-risk group respectively, and in the low-risk group the median duration for PFS and OS could not be reached (p=0.001).
Conclusions: The R-IPI is widely used to estimate the prognosis in DLBCL. But in our cohort, in the poor-risk patient group, the OS was 17 months according to R-IPI, while this period was 3 months according to PNI. This finding demonstrated that PNI might predict early mortality in DLBCL. |
| format | Article |
| id | doaj-art-cbab494da60442f8b4bc8a2c1ed32630 |
| institution | Kabale University |
| issn | 2149-2042 2149-4606 |
| language | English |
| publishDate | 2022-03-01 |
| publisher | Galenos Publishing House |
| record_format | Article |
| series | Medeniyet Medical Journal |
| spelling | doaj-art-cbab494da60442f8b4bc8a2c1ed326302025-01-30T07:15:46ZengGalenos Publishing HouseMedeniyet Medical Journal2149-20422149-46062022-03-01371859110.4274/MMJ.galenos.2022.87422MEDJ-87422Prognostic Nutritional Index Predicts Early Mortality in Diffuse Large B-cell LymphomaErman OZTURK0Tayfun ELIBOL1Emrah KILICASLAN2Beyza KABAYUKA3Işıl ERDOGAN OZUNAL4Istanbul Medeniyet University Faculty of Medicine, Department of Hematology, Istanbul, TurkeyIstanbul Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Clinic of Hematology, Istanbul, TurkeyIstanbul Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Clinic of Hematology, Istanbul, TurkeyIstanbul Medeniyet University Faculty of Medicine, Department of Internal Medicine, Istanbul, TurkeyIstanbul Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Clinic of Hematology, Istanbul, TurkeyObjective: The international prognostic index (IPI) and the revised IPI (R-IPI) are used to determine the prognosis in diffuse large B-cell lymphoma (DLBCL). However, these scoring systems are insufficient to identify very high-risk patients. Recently, the prognostic nutritional index (PNI) -calculated with lymphocyte count and albumin- has been used to determine the prognosis in DLBCL. This study aimed to evaluate the effect of PNI score on prognosis and survival in patients with high-risk DLBCL. Methods: Patients diagnosed with DLBCL and treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone were included. Pre-treatment IPI, R-IPI, and PNI scores and progression-free survival (PFS) and overall survival (OS) times were calculated. The cut-off value for PNI according to OS was determined by using the X-Tile program. Results: One hundred and ten patients were included, the median age was 63 years and the median follow-up period was 25 months. According to R-IPI, the me-dian OS could not be reached for the very good risk group, and the median OS values were 83 and 17 months in the good and poor-risk groups, respectively (p=0.001). The cohort was divided into three groups according to the cut-off value for the PNI: patients with PNI <33 were classified as high-risk, 33-42 intermediate-risk, and ≥42 as low-risk. According to PNI, the median durations of PFS and OS were 2 months and 3 months in the high-risk group, 9 months and 19 months in the inter-mediate-risk group respectively, and in the low-risk group the median duration for PFS and OS could not be reached (p=0.001). Conclusions: The R-IPI is widely used to estimate the prognosis in DLBCL. But in our cohort, in the poor-risk patient group, the OS was 17 months according to R-IPI, while this period was 3 months according to PNI. This finding demonstrated that PNI might predict early mortality in DLBCL.https://jag.journalagent.com/z4/download_fulltext.asp?pdir=medeniyet&un=MEDJ-87422diffuse large b-cell lymphomaprognostic nutritional indexsurvival |
| spellingShingle | Erman OZTURK Tayfun ELIBOL Emrah KILICASLAN Beyza KABAYUKA Işıl ERDOGAN OZUNAL Prognostic Nutritional Index Predicts Early Mortality in Diffuse Large B-cell Lymphoma Medeniyet Medical Journal diffuse large b-cell lymphoma prognostic nutritional index survival |
| title | Prognostic Nutritional Index Predicts Early Mortality in Diffuse Large B-cell Lymphoma |
| title_full | Prognostic Nutritional Index Predicts Early Mortality in Diffuse Large B-cell Lymphoma |
| title_fullStr | Prognostic Nutritional Index Predicts Early Mortality in Diffuse Large B-cell Lymphoma |
| title_full_unstemmed | Prognostic Nutritional Index Predicts Early Mortality in Diffuse Large B-cell Lymphoma |
| title_short | Prognostic Nutritional Index Predicts Early Mortality in Diffuse Large B-cell Lymphoma |
| title_sort | prognostic nutritional index predicts early mortality in diffuse large b cell lymphoma |
| topic | diffuse large b-cell lymphoma prognostic nutritional index survival |
| url | https://jag.journalagent.com/z4/download_fulltext.asp?pdir=medeniyet&un=MEDJ-87422 |
| work_keys_str_mv | AT ermanozturk prognosticnutritionalindexpredictsearlymortalityindiffuselargebcelllymphoma AT tayfunelibol prognosticnutritionalindexpredictsearlymortalityindiffuselargebcelllymphoma AT emrahkilicaslan prognosticnutritionalindexpredictsearlymortalityindiffuselargebcelllymphoma AT beyzakabayuka prognosticnutritionalindexpredictsearlymortalityindiffuselargebcelllymphoma AT isılerdoganozunal prognosticnutritionalindexpredictsearlymortalityindiffuselargebcelllymphoma |