Value of the prognostic nutritional index (PNI) in patients with newly diagnosed, CD5‐positive diffuse large B‐cell lymphoma: A multicenter retrospective study of the Huaihai Lymphoma Working Group

Abstract

BACKGROUND: CD5-positive diffuse large B-cell lymphoma (DLBCL) is a clinically rare subtype of DLBCL with aggressive clinical manifestations and a poor prognosis. It has been demonstrated that the prognostic nutritional index (PNI), an indicator of nutritional status and systemic inflammation, is a significant prognostic factor for several types of lymphoma. The objective of this multicenter retrospective study was to explore the prognostic value of the PNI in patients with CD5-positive DLBCL. METHODS: In total, 207 patients with CD5positive DLBCL were recruited from 11 centers of the Huaihai Lymphoma Working Group. Maximally selected rank statistics analysis was used to identify optimal cutoff points for the PNI. A Cox proportional hazards model was used for univariable and multivariable analyses. Kaplan-Meier curves were used to calculate survival rates and draw survival curves, and the log-rank test was used to compare differences between groups. RESULTS: The median age at diagnosis was 61 years, and the 5-year overall survival rate was 47.5%. According to the maximally selected rank statistics analysis, a score of 49.7 was the optimal cutoff point for the PNI. Subgroup analysis showed that the PNI could re-stratify patients in BCL-2-negative, MYC-negative, high-intermediate-risk and high-risk International Prognostic Index, BCL-6positive and BCL-6-negative, high Ki-67 score (≥0.9), Ann Arbor stage III/IV, Eastern Cooperative Oncology Group performance status ≥2, and germinal center B subgroups. Multivariable analysis revealed that PNI, age, Eastern Cooperative Oncology Group performance status, albumin level, and red blood cell count were independent prognostic factors for CD5-positive DLBCL. CONCLUSIONS: The PNI was a significant prognostic indicator for CD5-positive DLBCL and was able to re-stratify the prognosis for clinicopathologic subgroups of patients with CD5-positive DLBCL.

An Externally Validated Nomogram for Predicting the Overall Survival of Patients With Diffuse Large B-Cell Lymphoma Based on Clinical Characteristics and Systemic Inflammatory Markers

“…Low PNI has been associated with poor OS and PFS in many cancers, including DLBCL. 18 , 42 , 43 Shen Z et al also found that PNI was a powerful predictor that could re-stratify the prognosis of different clinicopathologic subgroups. 43 In our study, the prognostic value of PNI was also verified, and we found that it can be used as an independent predictor of OS in patients with DLBCL to predict patient prognosis.…”

“… 18 , 42 , 43 Shen Z et al also found that PNI was a powerful predictor that could re-stratify the prognosis of different clinicopathologic subgroups. 43 In our study, the prognostic value of PNI was also verified, and we found that it can be used as an independent predictor of OS in patients with DLBCL to predict patient prognosis. We further compared the differences in clinicopathological characteristics between the high PNI group and the low PNI group, and found that the low PNI levels may reflect higher tumor load and greater aggressiveness, which may lead to malnutrition and immunosuppression and are associated with poorer survival outcomes in patients with DLBCL.…”

Prognostic nutritional index during hospitalization correlates with adverse outcomes in elderly patients with acute myocardial infarction: a single-center retrospective cohort study

“…In addition to tumors, researchers have expanded the application of the PNI to the prognosis of other diseases such as COPD, lung transplantation, dilated cardiomyopathy, and heart failure. In most studies, the ideal PNI threshold has been between 40 and 50 [ 24 ], such as 36.7 in patients with late-stage biliary tract cancer and 51 in patients with breast cancer [ 25 , 26 ]. This study explored the optimal threshold of 40.923 in elderly patients with acute myocardial infarction.…”

The combination effect of RDW and PNI on the prognosis for CAD patients undergoing PCI

“…PNI was calculated from serum albumin levels and absolute lymphocyte counts, which was a comprehensive index re ected not only protein stores but also the immunological status. PNI plays a key role in assessing the prognosis of patients with a variety of diseases, including cancer, lymphoma, infectious diseases, and postoperative complications 11 . As an important component of PNI, serum albumin is an important antioxidant outside the cell.…”