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Low Geriatric Nutritional Risk Index Is Associated with Poorer Prognosis in Elderly Diffuse Large B-Cell Lymphoma Patients Unfit for Intensive Anthracycline-Containing Therapy: A Real-World Study

Nutritional assessments, including the Geriatric Nutritional Risk Index (GNRI), have emerged as prediction tools for long-term survival in various cancers. This study aimed to investigate the therapeutic strategy and explore the prognostic factors in the elderly patients (≥65 years) with diffuse lar...

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Autores principales: Chuang, Tzer-Ming, Liu, Yi-Chang, Hsiao, Hui-Hua, Wang, Hui-Ching, Du, Jeng-Shiun, Yeh, Tsung-Jang, Gau, Yuh-Ching, Ke, Ya-Lun, Yang, Ching-I, Lee, Ching-Ping, Hsu, Chin-Mu, Cho, Shih-Feng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8468689/
https://www.ncbi.nlm.nih.gov/pubmed/34579119
http://dx.doi.org/10.3390/nu13093243
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author Chuang, Tzer-Ming
Liu, Yi-Chang
Hsiao, Hui-Hua
Wang, Hui-Ching
Du, Jeng-Shiun
Yeh, Tsung-Jang
Gau, Yuh-Ching
Ke, Ya-Lun
Yang, Ching-I
Lee, Ching-Ping
Hsu, Chin-Mu
Cho, Shih-Feng
author_facet Chuang, Tzer-Ming
Liu, Yi-Chang
Hsiao, Hui-Hua
Wang, Hui-Ching
Du, Jeng-Shiun
Yeh, Tsung-Jang
Gau, Yuh-Ching
Ke, Ya-Lun
Yang, Ching-I
Lee, Ching-Ping
Hsu, Chin-Mu
Cho, Shih-Feng
author_sort Chuang, Tzer-Ming
collection PubMed
description Nutritional assessments, including the Geriatric Nutritional Risk Index (GNRI), have emerged as prediction tools for long-term survival in various cancers. This study aimed to investigate the therapeutic strategy and explore the prognostic factors in the elderly patients (≥65 years) with diffuse large B cell lymphoma (DLBCL). The cutoff value of the GNRI score (92.5) was obtained using the receiver operating characteristic curve. Among these patients (n = 205), 129 (62.9%) did not receive standard R–CHOP chemotherapy. Old age (≥80 years), poor performance status, low serum albumin level, and comorbidities were the major factors associated with less intensive anti-lymphoma treatment. Further analysis demonstrated that a lower GNRI score (<92.5) was linked to more unfavorable clinical features. In the patients who received non-anthracycline-containing regimens (non-R–CHOP), multivariate analysis showed that a low GNRI can serve as an independent predictive factor for worse progression-free (HR, 2.85; 95% CI, 1.05–7.72; p = 0.039) and overall survival (HR, 2.98; 95% CI, 1.02–8.90; p = 0.045). In summary, nutritional evaluation plays a role in DLBCL treatment and the GNRI score can serve as a feasible predictive tool for clinical outcomes in frail elderly DLBCL patients treated with non-anthracycline-containing regimens.
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spelling pubmed-84686892021-09-27 Low Geriatric Nutritional Risk Index Is Associated with Poorer Prognosis in Elderly Diffuse Large B-Cell Lymphoma Patients Unfit for Intensive Anthracycline-Containing Therapy: A Real-World Study Chuang, Tzer-Ming Liu, Yi-Chang Hsiao, Hui-Hua Wang, Hui-Ching Du, Jeng-Shiun Yeh, Tsung-Jang Gau, Yuh-Ching Ke, Ya-Lun Yang, Ching-I Lee, Ching-Ping Hsu, Chin-Mu Cho, Shih-Feng Nutrients Article Nutritional assessments, including the Geriatric Nutritional Risk Index (GNRI), have emerged as prediction tools for long-term survival in various cancers. This study aimed to investigate the therapeutic strategy and explore the prognostic factors in the elderly patients (≥65 years) with diffuse large B cell lymphoma (DLBCL). The cutoff value of the GNRI score (92.5) was obtained using the receiver operating characteristic curve. Among these patients (n = 205), 129 (62.9%) did not receive standard R–CHOP chemotherapy. Old age (≥80 years), poor performance status, low serum albumin level, and comorbidities were the major factors associated with less intensive anti-lymphoma treatment. Further analysis demonstrated that a lower GNRI score (<92.5) was linked to more unfavorable clinical features. In the patients who received non-anthracycline-containing regimens (non-R–CHOP), multivariate analysis showed that a low GNRI can serve as an independent predictive factor for worse progression-free (HR, 2.85; 95% CI, 1.05–7.72; p = 0.039) and overall survival (HR, 2.98; 95% CI, 1.02–8.90; p = 0.045). In summary, nutritional evaluation plays a role in DLBCL treatment and the GNRI score can serve as a feasible predictive tool for clinical outcomes in frail elderly DLBCL patients treated with non-anthracycline-containing regimens. MDPI 2021-09-17 /pmc/articles/PMC8468689/ /pubmed/34579119 http://dx.doi.org/10.3390/nu13093243 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Chuang, Tzer-Ming
Liu, Yi-Chang
Hsiao, Hui-Hua
Wang, Hui-Ching
Du, Jeng-Shiun
Yeh, Tsung-Jang
Gau, Yuh-Ching
Ke, Ya-Lun
Yang, Ching-I
Lee, Ching-Ping
Hsu, Chin-Mu
Cho, Shih-Feng
Low Geriatric Nutritional Risk Index Is Associated with Poorer Prognosis in Elderly Diffuse Large B-Cell Lymphoma Patients Unfit for Intensive Anthracycline-Containing Therapy: A Real-World Study
title Low Geriatric Nutritional Risk Index Is Associated with Poorer Prognosis in Elderly Diffuse Large B-Cell Lymphoma Patients Unfit for Intensive Anthracycline-Containing Therapy: A Real-World Study
title_full Low Geriatric Nutritional Risk Index Is Associated with Poorer Prognosis in Elderly Diffuse Large B-Cell Lymphoma Patients Unfit for Intensive Anthracycline-Containing Therapy: A Real-World Study
title_fullStr Low Geriatric Nutritional Risk Index Is Associated with Poorer Prognosis in Elderly Diffuse Large B-Cell Lymphoma Patients Unfit for Intensive Anthracycline-Containing Therapy: A Real-World Study
title_full_unstemmed Low Geriatric Nutritional Risk Index Is Associated with Poorer Prognosis in Elderly Diffuse Large B-Cell Lymphoma Patients Unfit for Intensive Anthracycline-Containing Therapy: A Real-World Study
title_short Low Geriatric Nutritional Risk Index Is Associated with Poorer Prognosis in Elderly Diffuse Large B-Cell Lymphoma Patients Unfit for Intensive Anthracycline-Containing Therapy: A Real-World Study
title_sort low geriatric nutritional risk index is associated with poorer prognosis in elderly diffuse large b-cell lymphoma patients unfit for intensive anthracycline-containing therapy: a real-world study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8468689/
https://www.ncbi.nlm.nih.gov/pubmed/34579119
http://dx.doi.org/10.3390/nu13093243
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