The value of prognostic nutritional index in nasal-type, extranodal natural killer/T-cell lymphoma

Li, Na; Jiang, Ming; Wu, Wanchun; Zou, Liqun

doi:10.1007/s00277-022-04849-0

Cited by 4 publications

(5 citation statements)

References 39 publications

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“…In the literature, the PNI has been widely associated with prognosis in ENKTL patients. 26 , 27 However, based on asparaginase‐based chemotherapy, there are no published data describing the correlation between the CONUT score and patient prognosis with ENKTL. To our best knowledge, this study is both the first and largest‐scale retrospective study centered on CONUT scores of ENKTL patients.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, a number of nutritional indexes have been found to be effective prognostic indicators for various cancers, such as the CONUT score and prognostic nutrition index (PNI). In the literature, the PNI has been widely associated with prognosis in ENKTL patients 26,27 . However, based on asparaginase‐based chemotherapy, there are no published data describing the correlation between the CONUT score and patient prognosis with ENKTL.…”

Section: Discussionmentioning

confidence: 99%

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A controlling nutritional status score is an independent predictor for patients with newly diagnosed nasal‐type extranodal NK/T‐cell lymphoma based on asparaginase‐containing regimens

Ren

Chen

et al. 2023

Cancer Medicine

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Background The controlling nutritional status (CONUT) score is a nutritional index that combines serum albumin, total cholesterol, and lymphocyte counts. The potential value of CONUT score for predicting clinical outcomes in patients with nasal‐type extranodal NK/T‐cell lymphoma (ENKTL) has not been explored. Methods This study included 374 ENKTL patients treated with asparaginase‐containing regimens from September 2012 to September 2017. Clinical characteristics, treatment efficacy, prognostic factors, and the predictive value of CONUT score were analyzed. Results The complete response (CR) and overall response rate (ORR) were 54.8% and 74.6%, respectively. Patients with CONUT scores <2 had higher CR and ORR compared to patients with scores ≥2 (69.1% vs. 48.9% for CR, p = 0.001; 90.0% vs. 74.6% for ORR, p < 0.001). The 5‐year overall survival (OS) and progression‐free survival (PFS) rates were 61.9% and 57.3%, respectively. Patients with CONUT scores <2 had better survival outcomes than those with scores ≥2 (5‐year OS, 76.1% vs. 56.0%, p < 0.001; 5‐year PFS, 74.4% vs. 50.1%, p < 0.001). CONUT score ≥2 was identified as an independent poor prognostic factor for both OS and PFS. A CONUT score ≥2 was also associated with poorer survival outcomes in low‐risk ENKTL patients. Conclusion A CONUT score ≥2 is a prognostic marker for poor survival in patients with ENKTL and could be used to stratify risk in low‐risk patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A controlling nutritional status score is an independent predictor for patients with newly diagnosed nasal‐type extranodal NK/T‐cell lymphoma based on asparaginase‐containing regimens

Ren

Chen

et al. 2023

Cancer Medicine

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“…In terms of prognostication, age >50 years was significantly correlated with inferior PFS and OS in univariate analysis in the present cohort, which was in agreement with multiple reports [8,25,26], and the cutoff value was determined as 50 instead of 60 years since patients >60 years only took up for a small proportion. B symptom(s) and poor physical performance status (ECOG score ≥2) were both predictors for inferior prognosis, which was also repetitively validated before [8,[27][28][29]. Although multiple studies [27,30,31] reported that decreased peripheral blood absolute LYMPH count correlated with worse survival outcomes, our analysis showed that elevated LYMPH count was an independent predictor for inferior OS, which might be due to the different inclusion criteria since early-stage patients made up the majority in most studies.…”

Section: Discussionmentioning

confidence: 59%

“…B symptom(s) and poor physical performance status (ECOG score ≥2) were both predictors for inferior prognosis, which was also repetitively validated before [8,[27][28][29]. Although multiple studies [27,30,31] reported that decreased peripheral blood absolute LYMPH count correlated with worse survival outcomes, our analysis showed that elevated LYMPH count was an independent predictor for inferior OS, which might be due to the different inclusion criteria since early-stage patients made up the majority in most studies.…”

Section: Discussionmentioning

confidence: 59%

Treatment and Prognosis of Newly Diagnosed Advanced-Stage Extranodal Natural Killer/T-Cell Lymphoma: A Single-Center Real-World Study across Two Decades

Wei,

Qi,

Chen

et al. 2023

Chemotherapy

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Introduction: Although there is now a consensus on asparaginase-based chemotherapy regimens in the treatment of advanced-stage extranodal natural killer/T-cell lymphomas (ENKTCLs), patient survival in the real-world setting is still not optimistic according to previous literature reports, and the optimal chemotherapeutic regimens and integration of different therapeutic methods under the concept of combined-modality treatment still need to be further explored and verified. Methods: Newly diagnosed stage Ⅲ/Ⅳ ENKTCL patients from Chinese National Cancer Center in the last two decades were retrospectively collected and analyzed. Overall survival (OS) and progression-free survival (PFS) were determined as primary endpoints. Log-rank tests and Cox proportional hazard models were performed to test for survival differences between subgroups and examine the univariable and multivariable associations. Results: The study included 83 newly diagnosed stage Ⅲ/Ⅳ ENKTCL patients and reported a median OS of 26.07 months and an estimated 5-year OS of 41.3% with a median follow-up of 82.13 months. First-line asparaginase-based regimens compared to non-asparaginase-based regimens significantly prolonged PFS (p = 0.007; HR = 0.48, p = 0.020) and showed a tendency to improve OS (p = 0.064; HR = 0.74, p = 0.359). Gemcitabine-based regimens also exhibited a trend toward improved PFS (p = 0.048; HR = 0.59, p = 0.164) and OS (p = 0.008; HR = 0.67, p = 0.282) compared to non-gemcitabine-based ones. The asparaginase and gemcitabine combinations yielded a 5-year OS of 55.0% and led to significantly superior PFS (p = 0.020; HR = 0.40, p = 0.022) and slightly better OS (p = 0.054; HR = 0.79, p = 0.495) compared to the remaining regimens. First-line combined-modality treatment integrating chemotherapy and radiotherapy improved PFS (p = 0.051) and OS (p = 0.036) compared to chemotherapy alone. Four autologous hematopoietic stem cell transplantation recipients reached a median OS of 58.34 months. Conclusion: Asparaginase and gemcitabine alone brought a favorable impact on PFS and OS; and the asparaginase and gemcitabine combination chemotherapy yielded the optimal efficacy, response duration, and survival outcomes. Combined-modality treatment including potent chemotherapy supplemented by radiotherapy and/or consolidative transplantation could improve prognosis in newly diagnosed advanced-stage ENKTCLs.

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“…Apart from these traditional scoring models, some other biomarkers were also used for ENKTL, for example, 25‐hydroxy vitamin D, 46 prognostic nutritional index, 47,48 C‐reactive protein to albumin ratio (CAR), 49 and maximum standardized uptake value (SUVmax) 33 . ctDNA analysis has increased sensitivity and specificity compared with the analysis of other circulating biomarkers and SUVmax 28,50,51 .…”

Section: Discussionmentioning

confidence: 99%

The Novel Prognostic Index Model of Combining Circulating Tumor DNA and PINK-E Predicts the Clinical Outcomes for Newly Diagnosed Extranodal NK/T-cell Lymphoma

Huang

et al. 2022

HemaSphere

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Extranodal NK/T-cell lymphoma (ENKTL) is a highly aggressive and heterogeneous disease with poor clinical outcome. Our previous work had demonstrated that circulating tumor DNA (ctDNA) analyses were feasible in ENKTL, and dynamic tracing of ctDNA could be used to monitor the disease status. However, the prognostic value of ctDNA in ENKTL has not been fully investigated. Patients with newly diagnosed ENKTL from February 2017 to December 2021 (n = 70) were enrolled. The pretreatment ctDNA concentration (hGE/ mL) was measured. The prognostic value of ctDNA, international prognostic index (IPI), Korean prognostic index (KPI), PINK-E, and the combination of PINK-E and ctDNA (PINK-EC) were investigated in our cohort. The IPI and PINK-E risk categories had a significant difference in progression-free survival (PFS) and overall survival (OS) between the low-risk and intermediate-risk groups. The KPI risk category had a difference in PFS and OS between the intermediate-risk and high-risk groups. Furthermore, integrating ctDNA into the PINK-E model could overcome the shortcomings of other prognostic models, which could significantly distinguish the different-risk groups. Overall, our results demonstrated that PINK-EC showed a superior prognostic prediction value and stability compared with IPI, KPI, and PINK-E. The integration of molecular features of the tumor into classic risk categories might better characterize a high-risk group where novel treatment approaches are most needed.

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The value of prognostic nutritional index in nasal-type, extranodal natural killer/T-cell lymphoma

Cited by 4 publications

References 39 publications

A controlling nutritional status score is an independent predictor for patients with newly diagnosed nasal‐type extranodal NK/T‐cell lymphoma based on asparaginase‐containing regimens

A controlling nutritional status score is an independent predictor for patients with newly diagnosed nasal‐type extranodal NK/T‐cell lymphoma based on asparaginase‐containing regimens

Treatment and Prognosis of Newly Diagnosed Advanced-Stage Extranodal Natural Killer/T-Cell Lymphoma: A Single-Center Real-World Study across Two Decades

The Novel Prognostic Index Model of Combining Circulating Tumor DNA and PINK-E Predicts the Clinical Outcomes for Newly Diagnosed Extranodal NK/T-cell Lymphoma

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