Yıl: 2022 Cilt: 37 Sayı: 1 Sayfa Aralığı: 85 - 91 Metin Dili: İngilizce DOI: 10.4274/MMJ.galenos.2022.87422 İndeks Tarihi: 23-06-2022

Prognostic Nutritional Index Predicts Early Mortality in Diffuse Large B-cell Lymphoma

Öz:
Objective: The international prognostic index (IPI) and the revised IPI (R-IPI) are used to determine the prognosis in diffuse large B-cell lymphoma (DLBCL). However, these scoring systems are insufficient to identify very high-risk patients. Recently, the prognostic nutritional index (PNI) -calculated with lymphocyte count and albumin- has been used to determine the prognosis in DLBCL. This study aimed to evaluate the effect of PNI score on prognosis and survival in patients with high-risk DLBCL. Methods: Patients diagnosed with DLBCL and treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone were included. Pre-treatment IPI, R-IPI, and PNI scores and progression-free survival (PFS) and overall survival (OS) times were calculated. The cut- off value for PNI according to OS was determined by using the X-Tile program. Results: One hundred and ten patients were included, the median age was 63 years and the median follow-up period was 25 months. According to R-IPI, the median OS could not be reached for the very good risk group, and the median OS values were 83 and 17 months in the good and poor-risk groups, respectively (p=0.001). The cohort was divided into three groups according to the cut-off value for the PNI: patients with PNI <33 were classified as high-risk, 33-42 intermediate-risk, and ≥42 as low-risk. According to PNI, the median durations of PFS and OS were 2 months and 3 months in the high-risk group, 9 months and 19 months in the intermediate-risk group respectively, and in the low-risk group the median duration for PFS and OS could not be reached (p=0.001). Conclusions: The R-IPI is widely used to estimate the prognosis in DLBCL. But in our cohort, in the poor-risk patient group, the OS was 17 months according to R-IPI, while this period was 3 months according to PNI. This finding demonstrated that PNI might predict early mortality in DLBCL.
Anahtar Kelime:

Prognostic Nutritional Index Predicts Early Mortality in Diffuse Large B-cell Lymphoma

Öz:
Amaç: Diffüz büyük B-hücreli lenfomada (DBBHL) prognozu belirlemede internasyonel prognostik indeks (IPI) ve revize edilmiş IPI (R-IPI) kullanılmaktadır. Ancak bu skorlama sistemleri çok yüksek riskli hastaları belirlemede yetersiz kalmaktadır. Son zamanlarda DBBHL’de prognozu belirlemede lenfosit ve albümin ile hesaplanan prognostik nutrisyonel indeks (PNİ) kullanılmaya başlanmıştır. Bu çalışmada amaç; DBBHL’de yüksek riskli hastalarda PNİ skorunun prognoz ve sağkalıma olan etkisini değerlendirmektir. Yöntemler: Çalışmaya DBBHL tanısı konmuş ve rituksimab, siklofosfamid, doksorubisin, vinkristin, prednizolon tedavisi almış hastalar alındı. Tedavi öncesi IPI, R-IPI ve PNİ skorları ile progresyonsuz sağkalım (PS) ve toplam sağkalım (TS) süreleri hesaplandı. TS’ye göre PNİ için sınır değer X-Tile programı ile belirlendi. Bulgular: Çalışmaya alınan 110 hastanın medyan yaşı 63, medyan takip süresi 25 aydı. R-IPI’ya göre çok iyi riskli grup için medyan TS süresine ulaşılamamışken, iyi ve kötü riskli gruplarda medyan TS sırası ile 83 ve 17 aydı (p=0,001). PNİ skoru için TS’de gruplar arasında fark yaratan sınır değere göre kohort üç gruba ayrıldı: PNİ<33 olan hastalar yüksek riskli, 33-42 arası orta riskli, PNİ≥42 olan hastalar iyi riskli olarak sınıflandırıldı. PNİ’ye göre medyan PS ve TS süreleri sırasıyla yüksek riskli grupta 2 ay ve 3 ay, orta riskli grupta 9 ay ve 19 aydı, iyi riskli grupta PS ve TS için medyan takip sürelerine ulaşılamadı (p=0,001). Sonuçlar: DBBHL’de prognozu belirlemede R-IPI kullanılmaktadır, fakat bizim kohortumuzda kötü riskli hasta grubunda R-IPI’ya göre hesaplanan TS 17 ay iken PNİ’ye göre bu sürenin 3 ay olduğu belirlenmiştir. Bu bulgu PNİ’nin erken mortaliteyi başarılı bir şekilde öngörebileceğini göstermektedir.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA OZTURK E, ELIBOL T, KILICASLAN E, KABAYUKA B, OZUNAL I (2022). Prognostic Nutritional Index Predicts Early Mortality in Diffuse Large B-cell Lymphoma. , 85 - 91. 10.4274/MMJ.galenos.2022.87422
Chicago OZTURK Erman,ELIBOL Tayfun,KILICASLAN Emrah,KABAYUKA Beyza,OZUNAL Isil ERDOGAN Prognostic Nutritional Index Predicts Early Mortality in Diffuse Large B-cell Lymphoma. (2022): 85 - 91. 10.4274/MMJ.galenos.2022.87422
MLA OZTURK Erman,ELIBOL Tayfun,KILICASLAN Emrah,KABAYUKA Beyza,OZUNAL Isil ERDOGAN Prognostic Nutritional Index Predicts Early Mortality in Diffuse Large B-cell Lymphoma. , 2022, ss.85 - 91. 10.4274/MMJ.galenos.2022.87422
AMA OZTURK E,ELIBOL T,KILICASLAN E,KABAYUKA B,OZUNAL I Prognostic Nutritional Index Predicts Early Mortality in Diffuse Large B-cell Lymphoma. . 2022; 85 - 91. 10.4274/MMJ.galenos.2022.87422
Vancouver OZTURK E,ELIBOL T,KILICASLAN E,KABAYUKA B,OZUNAL I Prognostic Nutritional Index Predicts Early Mortality in Diffuse Large B-cell Lymphoma. . 2022; 85 - 91. 10.4274/MMJ.galenos.2022.87422
IEEE OZTURK E,ELIBOL T,KILICASLAN E,KABAYUKA B,OZUNAL I "Prognostic Nutritional Index Predicts Early Mortality in Diffuse Large B-cell Lymphoma." , ss.85 - 91, 2022. 10.4274/MMJ.galenos.2022.87422
ISNAD OZTURK, Erman vd. "Prognostic Nutritional Index Predicts Early Mortality in Diffuse Large B-cell Lymphoma". (2022), 85-91. https://doi.org/10.4274/MMJ.galenos.2022.87422
APA OZTURK E, ELIBOL T, KILICASLAN E, KABAYUKA B, OZUNAL I (2022). Prognostic Nutritional Index Predicts Early Mortality in Diffuse Large B-cell Lymphoma. Medeniyet Medical Journal, 37(1), 85 - 91. 10.4274/MMJ.galenos.2022.87422
Chicago OZTURK Erman,ELIBOL Tayfun,KILICASLAN Emrah,KABAYUKA Beyza,OZUNAL Isil ERDOGAN Prognostic Nutritional Index Predicts Early Mortality in Diffuse Large B-cell Lymphoma. Medeniyet Medical Journal 37, no.1 (2022): 85 - 91. 10.4274/MMJ.galenos.2022.87422
MLA OZTURK Erman,ELIBOL Tayfun,KILICASLAN Emrah,KABAYUKA Beyza,OZUNAL Isil ERDOGAN Prognostic Nutritional Index Predicts Early Mortality in Diffuse Large B-cell Lymphoma. Medeniyet Medical Journal, vol.37, no.1, 2022, ss.85 - 91. 10.4274/MMJ.galenos.2022.87422
AMA OZTURK E,ELIBOL T,KILICASLAN E,KABAYUKA B,OZUNAL I Prognostic Nutritional Index Predicts Early Mortality in Diffuse Large B-cell Lymphoma. Medeniyet Medical Journal. 2022; 37(1): 85 - 91. 10.4274/MMJ.galenos.2022.87422
Vancouver OZTURK E,ELIBOL T,KILICASLAN E,KABAYUKA B,OZUNAL I Prognostic Nutritional Index Predicts Early Mortality in Diffuse Large B-cell Lymphoma. Medeniyet Medical Journal. 2022; 37(1): 85 - 91. 10.4274/MMJ.galenos.2022.87422
IEEE OZTURK E,ELIBOL T,KILICASLAN E,KABAYUKA B,OZUNAL I "Prognostic Nutritional Index Predicts Early Mortality in Diffuse Large B-cell Lymphoma." Medeniyet Medical Journal, 37, ss.85 - 91, 2022. 10.4274/MMJ.galenos.2022.87422
ISNAD OZTURK, Erman vd. "Prognostic Nutritional Index Predicts Early Mortality in Diffuse Large B-cell Lymphoma". Medeniyet Medical Journal 37/1 (2022), 85-91. https://doi.org/10.4274/MMJ.galenos.2022.87422