Prognostic nutritional index and the prognosis of diffuse large b-cell lymphoma: a meta-analysis

BACKGROUND: Some studies have investigated the prognostic value exhibited by the Prognostic Nutritional Index (PNI) in patients suffering diffuse large B-cell lymphoma (DLBCL), but varying results were obtained. In order to determine the specific prognostic value more accurately, a meta-analysis was conducted in this study. METHODS: Literatures were searched from the China National Knowledge Infrastructure (CNKI), Wanfang, PubMed, Embase, the Cochrane Library, and Web of Science. Pooled hazard ratio (HR) and the 95% confidence interval (CI) were calculated to assess the association between PNI and the overall survival (OS) and the progression-free survival (PFS) of patients with DLBCL. RESULTS: Based on seven studies with a total number of 1311 patients, our meta-analysis revealed that low PNI may meant poor OS (HR = 2.14, 95% CI 1.66–2.75, p < 0.001) and poor PFS (HR = 1.75, 95% CI 1.36–2.25, p = 0.438). Subgroup analysis showed that, in Asians, low PNI was correlated to poor OS (pooled HR = 2.06 95% CI 1.59–2.66) and poor PFS (pooled HR = 1.66, 95% CI 1.28–2.15). Similar results were obtained from one European study, which is the only study performed outside of Asia from our literature search. CONCLUSION: For patients with DLBCL, low PNI may be interpreted as adverse prognosis. More data from European patients are required in this study to avoid analysis bias.