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The pretreatment Controlling Nutritional Status score is an independent prognostic factor in elderly patients with diffuse large B-cell lymphoma.

Yuto KanedaNobuhiro KanemuraNobuhiko NakamuraYoshikazu IkomaKimihiro YamaguchiEri TakadaYuhei ShibataShin LeeKei FujitaTetsuji MorishitaTakuro MatsumotoHiroshi NakamuraJunichi KitagawaSenji KasaharaTakeshi HaraHisashi TsurumiMasahito Shimizu
Published in: Leukemia & lymphoma (2023)
Predicting prognosis is crucial in older patients with diffuse large B-cell lymphoma (DLBCL). This study evaluated the prognostic impact of the controlling nutritional status (CONUT) score, a simple nutritional index, for older DLBCL patients (≥65 years of age) treated with R-CHOP-like regimens in a retrospective, cohort study including 203 patients. The CONUT score was an independent prognostic factor for overall survival (hazard ratio 1.11, 95% confidence interval (CI) 1.01-1.21, p  = 0.032) in a multivariable Cox proportional hazards model. On receiver-operating characteristic analysis, the optimal cutoff value was 3. The CONUT score (≥3 or <3) effectively stratified older DLBCL patients, regardless of the International Prognostic Index ( p  = 0.71 for interaction). Further, the CONUT score independently affected initial dose intensity (odds ratio 0.84, 95% CI 0.73-0.95, p  = 0.008), likely reflecting the patients' status at diagnosis and affecting dose adjustments. In conclusion, the CONUT score is associated with a poorer prognosis in older DLBCL patients.
Keyphrases
  • diffuse large b cell lymphoma
  • prognostic factors
  • end stage renal disease
  • newly diagnosed
  • ejection fraction
  • chronic kidney disease
  • peritoneal dialysis
  • physical activity
  • epstein barr virus
  • high intensity