The Value of Prognostic Nutritional Index (PNI) on Newly Diagnosed Diffuse Large B-Cell Lymphoma Patients: A Multicenter Retrospective Study of HHLWG Based on Propensity Score Matched Analysis

Ziyuan Shen; Fei Wang; Chenlu He; Dashan Li; Shanlin Nie; Zhenzhen Bian; Mingkang Yao; Yuhao Xue; Ying Wang; Weiying Gu; Taigang Zhu; Yuye Shi; Hao Zhang; Shuiping Huang; Yuqing Miao; Wei Sang; Huaihai Lymphoma Working Group

doi:10.2147/JIR.S340822

The Value of Prognostic Nutritional Index (PNI) on Newly Diagnosed Diffuse Large B-Cell Lymphoma Patients: A Multicenter Retrospective Study of HHLWG Based on Propensity Score Matched Analysis

J Inflamm Res. 2021 Oct 27:14:5513-5522. doi: 10.2147/JIR.S340822. eCollection 2021.

Authors

Ziyuan Shen^#¹, Fei Wang^#², Chenlu He^#¹, Dashan Li³, Shanlin Nie³, Zhenzhen Bian³, Mingkang Yao⁴, Yuhao Xue⁵, Ying Wang⁶, Weiying Gu², Taigang Zhu⁷, Yuye Shi⁵, Hao Zhang⁴, Shuiping Huang^{1

8}, Yuqing Miao⁹, Wei Sang³; Huaihai Lymphoma Working Group

Affiliations

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.

^# Contributed equally.

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.

Keywords: diffuse large B-cell lymphoma; prognosis; prognostic nutrition index; propensity score matched.

Grants and funding

This study was funded by Natural Science Foundation of Jiangsu Province, Grant/Award Number: BK20171181; Jiangsu Key Research and Development Project of Social Development, Grant/Award Number: BE2019638; Young Medical Talents of Jiangsu Science and Education Health Project, Grant/Award Number: QNRC2016791.