Validation and comparison of prognostic values of GNRI, PNI, and CONUT in newly diagnosed diffuse large B cell lymphoma
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ORIGINAL ARTICLE
Validation and comparison of prognostic values of GNRI, PNI, and CONUT in newly diagnosed diffuse large B cell lymphoma Toshihiro Matsukawa 1 & Keito Suto 1,2 & Minoru Kanaya 3 & Koh Izumiyama 3 & Koichiro Minauchi 2 & Shota Yoshida 1 & Hisashi Oda 1 & Takuto Miyagishima 1 & Akio Mori 3 & Shuichi Ota 2 & Daigo Hashimoto 4 & Takanori Teshima 4 & North Japan Hematology Study Group (NJHSG) Received: 9 July 2020 / Accepted: 7 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Diffuse large B cell lymphoma (DLBCL) is the most common type of aggressive non-Hodgkin lymphoma. Emerging evidence indicates that poor nutritional status determined with nutritional indices such as geriatric nutritional risk index (GNRI), prognostic nutritional index (PNI), and controlling nutritional status score (CONUT) was associated with poor prognosis of DLBCL. We conducted this multicenter retrospective study to validate and compare prognostic values of the three indices in 615 newly diagnosed DLBCL patients. The overall survival (OS) in patients with poor nutritional status determined with each of these nutritional indices were significantly inferior compared with that in those without nutritional risks (5-year OS in patients with GNRI < 95.7 and GNRI ≥ 95.7 were 56.4% and 83.5%, P < 0.001; PNI < 42.4 and PNI ≥ 42.4 were 56.1% and 81.0%, P < 0.001; CONUT > 4 and CONUT ≤ 4 were 53.1% and 77.1%, P < 0.001). GNRI and CONUT were independent prognostic predictors for OS (GNRI < 95.7, hazard ratio [HR] 1.83, 95% confidence interval [CI] 1.22–2.74, P = 0.0032; CONUT > 4, HR 1.53, 95% CI 1.05–2.23, P = 0.028) after multivariate analyses. Nutritional status determined with GNRI affected OS more strongly in the patients with nongerminal center B cell–like (nonGCB) DLBCL compared with that in those with GCB-type DLBCL. In conclusion, baseline poor nutritional status determined based on GNRI or CONUT was an independent risk factor of newly diagnosed DLBCL, and GNRI was also useful as an independent prognostic factor for patients with nonGCB-type DLBCL. Keywords Diffuse large B cell lymphoma . Nutrition . Geriatric nutritional risk index . Prognostic nutritional index . Controlling nutritional status score
Introduction Toshihiro Matsukawa and Keito Suto contributed equally to this work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00277-020-04262-5) contains supplementary material, which is available to authorized users. * Toshihiro Matsukawa [email protected] 1
Department of Internal Medicine/Hematology, Kushiro Rosai Hospital, 13-23 Nakazono-Cho, Kushiro 085-8533, Japan
2
Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan
3
Blood Disorders Center, Aiiku Hospital, Sapporo, Japan
4
Department of Hematology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
Diffuse large B cell lymphoma (DLBCL) is an aggressive and genetically heterogeneous B cell neoplasm accounting for ~ 35%
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