Ziyuan Shen1, Fei Wang2, Chenlu He1, Dashan Li3, Shanlin Nie3, Zhenzhen Bian3, Mingkang Yao4, Yuhao Xue5, Ying Wang6, Weiying Gu2, Taigang Zhu7, Yuye Shi5, Hao Zhang4, Shuiping Huang1,8, Yuqing Miao9, Wei Sang3. 1. Department of Epidemiology and Biostatistics, Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China. 2. Department of Hematology, The First People's Hospital of Changzhou, Changzhou, Jiangsu, People's Republic of China. 3. Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China. 4. Department of Hematology, Affiliated Hospital of Jining Medical University, Jining, Shandong, People's Republic of China. 5. Department of Hematology, The First People's Hospital of Huaian, Huaian, Jiangsu, People's Republic of China. 6. Department of Personnel, Suqian First Hospital, Suqian, Jiangsu, People's Republic of China. 7. Department of Hematology, The General Hospital of Wanbei Coal-Electric Group, Suzhou, People's Republic of China. 8. Center for Medical Statistics and Data Analysis, Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China. 9. Department of Hematology, Yancheng First People's Hospital, Yancheng, Jiangsu, People's Republic of China.
Abstract
INTRODUCTION: Immunonutritional status is associated with the survival of DLBCL. This multicenter retrospective study aimed to explore the prognostic value of Prognostic Nutrition Index (PNI) in DLBCL patients by using propensity score matched analysis (PSM). METHODS: A total of 990 DLBCL cases were recruited from 5 centers of Huaihai Lymphoma Working Group (HHLWG). A 1:1 PSM analysis was performed using the nearest-neighbor method, with a caliper size of 0.02. Cox regression analysis was used to examine factors associated with survival. RESULTS: The median age at diagnosis was 62 years and 52.5% were males, with the 3-y overall survival of 65.1%. According to the MaxStat analysis, 44 was the optimal cut-off point of PNI. After PSM analysis, a total of 282 patients in PNI < 44 group could be propensity matched to PNI ≥ 44 patients, creating a group of 564 patients. Multivariable analysis revealed that PNI, age, central nervous system involvement and International Prognostic Index (IPI) were independent prognostic factors for DLBCL. Kaplan-Meier analysis indicated that patients with low PNI in Ann Arbor Stage (III/VI), ECOG (<2), IPI (LR+LIR), GCB, and BCL-2 negative groups had a poor prognosis. DISCUSSION: PNI could accurately stratify the prognosis of DLBCL after PSM analysis.
INTRODUCTION: Immunonutritional status is associated with the survival of DLBCL. This multicenter retrospective study aimed to explore the prognostic value of Prognostic Nutrition Index (PNI) in DLBCL patients by using propensity score matched analysis (PSM). METHODS: A total of 990 DLBCL cases were recruited from 5 centers of Huaihai Lymphoma Working Group (HHLWG). A 1:1 PSM analysis was performed using the nearest-neighbor method, with a caliper size of 0.02. Cox regression analysis was used to examine factors associated with survival. RESULTS: The median age at diagnosis was 62 years and 52.5% were males, with the 3-y overall survival of 65.1%. According to the MaxStat analysis, 44 was the optimal cut-off point of PNI. After PSM analysis, a total of 282 patients in PNI < 44 group could be propensity matched to PNI ≥ 44 patients, creating a group of 564 patients. Multivariable analysis revealed that PNI, age, central nervous system involvement and International Prognostic Index (IPI) were independent prognostic factors for DLBCL. Kaplan-Meier analysis indicated that patients with low PNI in Ann Arbor Stage (III/VI), ECOG (<2), IPI (LR+LIR), GCB, and BCL-2 negative groups had a poor prognosis. DISCUSSION: PNI could accurately stratify the prognosis of DLBCL after PSM analysis.