Contributions
Abstract: PB1783
Type: Publication Only
Background
Cachexia is an indicator of tumor progression in patients with malignancy. Cachectic patients are intolerant to cytotoxic chemotherapy, exhibit a reduced response to antitumor therapy, and have an unfavorable prognosis. An international consensus proposed diagnostic criteria for cancer cachexia including weight loss, low body mass index (BMI), and/or presence of sarcopenia. Other potential biomarkers (e.g., albumin, C-reactive protein, pro-inflammatory cytokines, and microRNAs) and scoring systems (e.g., cachexia score [CASCO], Glasgow prognostic score [GPS], prognostic nutritional index [PNI]) have also been studied to diagnose cancer cachexia and assess its severity.
Aims
We evaluated the association between the prognostic nutritional index (PNI) and the clinical features of diffuse large B-cell lymphoma (DLBCL) and developed a novel prognostic model using a nomogram including the PNI and other biomarkers for cancer cachexia.
Methods
PNI was positively correlated with skeletal muscle index, body mass index, and serum levels of albumin. The low PNI group had a lower complete response rate (60.3% vs. 87.6%), increased treatment-related toxicity, and more frequent treatment discontinuation (43.5% vs. 8.8%) than the high PNI group. The median OS was shorter in the low PNI group than the high PNI group (15.6 months vs. not reached; p < 0.001). Multivariate Cox regression analyses showed that PNI, sarcopenia, and the international prognostic index (IPI) were independent prognostic factors for OS. The nomogram developed using this regression model showed excellent discriminatory ability for predicting OS (c-index, 0.80) compared to the IPI alone (c-index, 0.75).
Results
PNI was positively correlated with skeletal muscle index, body mass index, and serum levels of albumin. The low PNI group had a lower complete response rate (60.3% vs. 87.6%), increased treatment-related toxicity, and more frequent treatment discontinuation (43.5% vs. 8.8%) than the high PNI group. The median OS was shorter in the low PNI group than the high PNI group (15.6 months vs. not reached; p < 0.001). Multivariate Cox regression analyses showed that PNI, sarcopenia, and the international prognostic index (IPI) were independent prognostic factors for OS. The nomogram developed using this regression model showed excellent discriminatory ability for predicting OS (c-index, 0.80) compared to the IPI alone (c-index, 0.75).
Conclusion
Low PNI was associated with adverse clinical features in patients with DLBCL. The proposed nomogram supports the clinical impact of cachexia on survival and may contribute to individualized therapy in patients with DLBCL.
Session topic: 21. Aggressive Non-Hodgkin lymphoma - Clinical
Keyword(s): Diffuse large B cell lymphoma, Lymphocyte, prognosis, Survival
Abstract: PB1783
Type: Publication Only
Background
Cachexia is an indicator of tumor progression in patients with malignancy. Cachectic patients are intolerant to cytotoxic chemotherapy, exhibit a reduced response to antitumor therapy, and have an unfavorable prognosis. An international consensus proposed diagnostic criteria for cancer cachexia including weight loss, low body mass index (BMI), and/or presence of sarcopenia. Other potential biomarkers (e.g., albumin, C-reactive protein, pro-inflammatory cytokines, and microRNAs) and scoring systems (e.g., cachexia score [CASCO], Glasgow prognostic score [GPS], prognostic nutritional index [PNI]) have also been studied to diagnose cancer cachexia and assess its severity.
Aims
We evaluated the association between the prognostic nutritional index (PNI) and the clinical features of diffuse large B-cell lymphoma (DLBCL) and developed a novel prognostic model using a nomogram including the PNI and other biomarkers for cancer cachexia.
Methods
PNI was positively correlated with skeletal muscle index, body mass index, and serum levels of albumin. The low PNI group had a lower complete response rate (60.3% vs. 87.6%), increased treatment-related toxicity, and more frequent treatment discontinuation (43.5% vs. 8.8%) than the high PNI group. The median OS was shorter in the low PNI group than the high PNI group (15.6 months vs. not reached; p < 0.001). Multivariate Cox regression analyses showed that PNI, sarcopenia, and the international prognostic index (IPI) were independent prognostic factors for OS. The nomogram developed using this regression model showed excellent discriminatory ability for predicting OS (c-index, 0.80) compared to the IPI alone (c-index, 0.75).
Results
PNI was positively correlated with skeletal muscle index, body mass index, and serum levels of albumin. The low PNI group had a lower complete response rate (60.3% vs. 87.6%), increased treatment-related toxicity, and more frequent treatment discontinuation (43.5% vs. 8.8%) than the high PNI group. The median OS was shorter in the low PNI group than the high PNI group (15.6 months vs. not reached; p < 0.001). Multivariate Cox regression analyses showed that PNI, sarcopenia, and the international prognostic index (IPI) were independent prognostic factors for OS. The nomogram developed using this regression model showed excellent discriminatory ability for predicting OS (c-index, 0.80) compared to the IPI alone (c-index, 0.75).
Conclusion
Low PNI was associated with adverse clinical features in patients with DLBCL. The proposed nomogram supports the clinical impact of cachexia on survival and may contribute to individualized therapy in patients with DLBCL.
Session topic: 21. Aggressive Non-Hodgkin lymphoma - Clinical
Keyword(s): Diffuse large B cell lymphoma, Lymphocyte, prognosis, Survival