Prognostic impact of nutritional and inflammation-based risk scores in follicular lymphoma in the era of anti-CD20 targeted treatment strategies

Gebauer, Niklas; Mengler, Britta; Kopelke, Svenja; Frydrychowicz, Alex; Fürschke, Alexander; Hackenbroch, Carsten; Bauer, Arthur; Riecke, Armin; Bubnoff, Nikolaus von; Fetscher, Sebastian; Witte, Hanno M

doi:10.1007/s00432-021-03758-5

Cited by 7 publications

(9 citation statements)

References 62 publications

(85 reference statements)

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“…Follow-up was conducted by consulting hospitalization records and telephone interviews until March 2022, from initial diagnosis to follow-up deadline or date of death. Overall survival (OS) was defined as the time from the date of diagnosis to death or last observation for any cause, Progression-free survival (PFS) was defined as that from the date of diagnosis to first relapse, progression or death and date of the last follow-up ( 18 , 19 ). Progression of disease within 24 months was defined as POD24 ( 20 ).…”

Section: Methodsmentioning

confidence: 99%

The prognostic nutritional index, an independent predictor of overall survival for newly diagnosed follicular lymphoma in China

Lei²,

Wen³

et al. 2022

Front. Nutr.

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ObjectiveThe prognostic nutritional index (PNI) is an important prognostic factor for survival outcomes in various hematological malignancies. The current study focused on exploring the predictive value of the PNI in newly diagnosed follicular lymphoma (FL) in China.Materials and methodsThe clinical indicators and follow-up data of 176 patients who received chemotherapy or immunotherapy combined with chemotherapy with FL in our hospital from January 2016 to March 2022 were retrospectively analyzed. Cox proportional hazard model was used for univariate and multivariate analyses. Kaplan–Meier curves were used to calculate survival rates and draw survival curves. The log-rank test was applied to compare differences between groups.ResultsThe optimal cut-off value of PNI was 44.3. All patients were divided into a high PNI group (>44.3) and a low PNI group (≤44.3). The low PNI group had a low CR rate and a high risk of death, with a tendency toward POD24, and Both OS and PFS were worse than those in the high PNI group. PNI was able to predict OS and PFS in FL patients and was the only independent predictor of OS (P = 0.014 HR 5.024; 95%CI 1.388∼18.178) in multivariate analysis. PNI could re-stratify patients into groups of high FLIPI score, high FLIPI2 score, no POD24, and rituximab combined with chemotherapy. Moreover, integrating PNI into the FLIPI and FLIPI2 models improved the area under the curve (AUC) for more accurate survival prediction and prognosis.ConclusionPNI is a significant prognostic indicator for newly diagnosed FL in China that can early identify patients with poor prognosis and guide clinical treatment decisions.

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Section: Methodsmentioning

confidence: 99%

The prognostic nutritional index, an independent predictor of overall survival for newly diagnosed follicular lymphoma in China

Lei²,

Wen³

et al. 2022

Front. Nutr.

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“…[84][85][86] Finally, in 209 patients with FL, a retrospective multicenter study showed prognostic impact of GPS on OS and PFS. 87…”

Section: Glasgow Prognostic Scorementioning

confidence: 99%

“…Based on the concentration of C‐reactive protein and albumin, GPS has been derived from patients with various types of cancer and validated in multiple cohorts 84–86 . Finally, in 209 patients with FL, a retrospective multicenter study showed prognostic impact of GPS on OS and PFS 87 …”

Section: Reviewmentioning

confidence: 99%

Host‐related factors and cancer: Malnutrition and non‐Hodgkin lymphoma

Mancuso

Mattana

Santoro

et al. 2022

Hematological Oncology

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Assessment of host‐related factors is a crucial aspect in the comprehensive management of cancer patients. A distinct nutritional disturbance linked to cancer has been recognized to be associated with negative outcomes. However, compared to solid tumors, only a limited number of studies have looked specifically at nutritional issues in the field of lymphoma. The aim of this review is to integrate the current knowledge on interactions between malnutrition and lymphoma and address most relevant and pertinent questions. We first provide a literature review on the mutual biological relationship between malnutrition and lymphoma. Next, we explore the overlap between malnutrition, sarcopenia, cachexia and frailty in lymphoma studies. In addition, we summarize the clinical assessment scales used to measure malnutrition in lymphoma subjects. Furthermore, we address the problem of nutritional interventions aimed at patients who are candidates for treatment for lymphoma. Malnutrition can arise as a consequence of lymphoma disease and can in turn promote lymphomagenesis, negatively affect the response to therapy and favor adverse event to treatment. There is increasing evidence that malnutrition, sarcopenia and cachexia in lymphoma are intimately inter‐related and are a hallmark of frailty. A variety of different tools are recorded with the apparent ability to describe nutritional status and to impact prognosis in lymphoma patients. Finally, a network of prognostic host‐ and disease‐related factors is proposed where malnutrition can interact with each other in complex ways.

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“…The cut-off values of Ki-67 for optimal risk stratification are discussed conversely [ 29 , 30 , 31 ]. Among a large spectrum of solid tumors and hematological malignancies, it has been shown that the Glasgow Prognostic Score (GPS) reflects a representative and handy tool to identify cancer patients at risk for both early progression and all-cause mortality [ 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ]. GPS examines two essential mechanisms of tumor growth, progression and aggressiveness.…”

Section: Introductionmentioning

confidence: 99%

“…GPS examines two essential mechanisms of tumor growth, progression and aggressiveness. The first is systemic inflammation (via the C-reactive protein) and the second is the nutritional status of a cancer patient (via albumin) at the initial diagnosis [ 35 ]. In recent years, the impressive predictive capabilities of both factors have been demonstrated in cancer patients.…”

Section: Introductionmentioning

confidence: 99%

The Glasgow Prognostic Score Predicts Survival Outcomes in Neuroendocrine Neoplasms of the Gastro–Entero–Pancreatic (GEP-NEN) System

Gebauer

Ziehm

Gebauer

et al. 2022

Cancers

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Background: Across a variety of solid tumors, prognostic implications of nutritional and inflammation-based risk scores have been identified as a complementary resource of risk stratification. Methods: In this retrospective study, we performed a comparative analysis of several established risk scores and ratios, such as the Glasgow Prognostic Score (GPS), in neuroendocrine neoplasms of the gastro–entero–pancreatic (GEP-NEN) system with respect to their prognostic capabilities. Clinicopathological and treatment-related data for 102 GEP-NEN patients administered to the participating institutions between 2011 and 2021 were collected. Scores/ratios significantly associated with overall or progression-free survival (OS, PFS) upon univariate analysis were subsequently included in a Cox-proportional hazard model for the multivariate analysis. Results: The median age was 62 years (range 18–95 years) and the median follow-up period spanned 51 months. Pancreatic or intestinal localization at the initial diagnosis were present in 41 (40.2%) and 44 (43.1%) cases, respectively. In 17 patients (16.7%), the primary manifestation could not be ascertained (NNUP; neuroendocrine neoplasms of unknown primary). Histological grading (HG) revealed 24/102 (23.5%) NET/NEC (poorly differentiated; high grade G3) and 78/102 (76.5%) NET (highly or moderately differentiated; low–high grade G1–G2). In total, 53/102 (51.9%) patients presented with metastatic disease (UICC IV), 11/102 (10.7%) patients presented with multifocal disease, and 56/102 (54.9%) patients underwent a primary surgical or endoscopic approach, whereas 28 (27.5%) patients received systemic cytoreductive treatment. The univariate analysis revealed the GPS and PI (prognostic index), as well as UICC-stage IV, HG, and the Charlson comorbidity index (CCI) to predict both the PFS and OS in GEP-NEN patients. However, the calculation of the survival did not separate GPS subgroups at lower risk (GPS 0 versus GPS 1). Upon the subsequent multivariate analysis, GPS was the only independent predictor of both OS (p < 0.0001; HR = 3.459, 95% CI = 1.263–6.322) and PFS (p < 0.003; HR = 2.119, 95% CI = 0.944–4.265). Conclusion: In line with previous results for other entities, the present study revealed the GPS at baseline to be the only independent predictor of survival across all stages of GEP-NEN, and thus supports its clinical utility for risk stratification in this group of patients.

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Prognostic impact of nutritional and inflammation-based risk scores in follicular lymphoma in the era of anti-CD20 targeted treatment strategies

Cited by 7 publications

References 62 publications

The prognostic nutritional index, an independent predictor of overall survival for newly diagnosed follicular lymphoma in China

The prognostic nutritional index, an independent predictor of overall survival for newly diagnosed follicular lymphoma in China

Host‐related factors and cancer: Malnutrition and non‐Hodgkin lymphoma

The Glasgow Prognostic Score Predicts Survival Outcomes in Neuroendocrine Neoplasms of the Gastro–Entero–Pancreatic (GEP-NEN) System

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