Lower Body Mass Index and Prognostic Nutritional Index Are Associated with Poor Posttransplant Outcomes in Lymphoma Patients Undergoing Autologous Stem Cell Transplantation

Abstract

Background: Pre-transplant inflammatory and nutritional status has not been widely explored in terms of its impact on autologous hematopoietic stem cell transplantation (auto-HSCT) outcomes in lymphoma patients. We aimed to evaluate the impact of body mass index (BMI), prognostic nutri-tional index (PNI), and C-reactive protein to albumin ratio (CAR) on auto-HSCT outcomes. Meth-od: We retrospectively analyzed 87 consecutive lymphoma patients who underwent their first auto-HSCT at the Adult Hematopoietic Stem Cell Transplantation Unit at Akdeniz University Hospital. Result: CAR had no impact on post-transplant outcomes. PNI≤50 was an independent prognostic factor for both shorter progression free survival (PFS) (hazard ratio [HR]=2.43, P = .025) and worse overall survival (OS) (HR=2.93, P = .021), respectively. The 5-year PFS rate was significantly lower in patients with PNI≤50 than in patients with PNI>50 (37.3% vs. 59.9%, P = .003). The 5-year OS rate in patients with PNI≤50 had significantly low when compared with patients who had PNI>50 as well (45.5% vs. 67.2%, P = .011). Patients with BMI<25 had higher 100-day TRM compared with patients with BMI≥25 (14.7% vs 1.9%, P = .020). BMI<25 was an independent prognostic factor associated with shorter PFS and OS (HR=2.98, P = .003, HR=5.06, P < .001, respectively). The 5-year PFS rate was significantly lower in patients with BMI<25 than patients with BMI≥25 (40.2% vs. 53.7%, P = .037). Similarly, the 5-year OS rate in patients with BMI<25 had significant-ly inferior compared to patients with BMI≥25 (42.7% vs. 64.7%, P = .002). Conclusion: Our study confirms that lower BMI and CAR have negative impacts on auto-HSCT outcomes in lymphoma patients. Furthermore, higher BMI should not be considered an obstacle for lymphoma patients who need auto-HSCT, conversely, it could be an advantage for post-transplant outcomes. Keywords: Lymphoma, autologous hematopoietic stem cell transplantation, body mass index, prognostic nutritional index

The Critical Exploration into Current Evidence behind the Role of the Nutritional Support in Adult Patients Who Undergo Haematogenic Stem Cell Transplantation

“…Body structure should be consistently assessed in patients undergoing HSCT. The body weight, skin fold thickness, and arm and arm muscle diameter are measured, and BMI should be calculated [ 31 , 40 , 41 ]. However, there are many conditions and parameters which might present as a limitation for this type of nutritional assessment in haemato-oncological patients undergoing HSCT.…”