Abstract
The prognostic nutritional index (PNI), an indicator of nutritional status and systemic inflammation, is associated with survival in several types of tumors. The prognostic value of the PNI in lymphoma remains unclear. The present study aimed to evaluate the prognostic significance of the PNI in patients with extranodal natural killer/T cell lymphoma, nasal type (ENKTL). This retrospective study in two institutions was comprised of 177 patients with newly diagnosed ENKTL. Patients with a combined albumin (g/L) + 5 × total lymphocyte count × 109/l ≥ 45 were allocated a PNI score of 0. Patients in whom this total was <45 were allocated a score of 1. Patients with a pretreatment PNI score of 1 had more adverse clinical features, lower complete remission rates (p = 0.005), and worse overall survival (OS, p < 0.001) and progression-free survival (p = 0.004) compared with those with a PNI score of 0. Multivariate analysis showed that the PNI (p < 0.001) and tumor mass ≥5 cm (p < 0.001) were independent predictors of worse OS. The PNI was predictive in extranasal disease and nasal disease (both p < 0.05). The PNI could differentiate low-risk patients as classified according to the International Prognostic Index and Prognosis Index for peripheral T cell lymphoma scoring, as well as patients in a different category using the Korean Prognostic Index scores with different survival outcomes (all p < 0.05). The PNI is a powerful predictor of survival in ENKTL. Nutritional status and inflammatory responses at diagnosis might play an important role in survival in patients with ENKTL.
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Acknowledgments
This work was supported by the National Natural Science Foundation of China (no. 81372883, 81001052, and 81172244), the Science and Technology Planning Project of Guangdong Province, China (no. 2011B031800222), Young Talents Project of Sun Yat-Sen University Cancer Center (to Cai Qingqing), Young Talents Project of Sun Yat-Sen University (to Cai Qingqing), the Natural Science Foundation of Guangdong Province, China (no. 8151008901000043), and the Foundation of Novartis Pharma (to Cai Qingqing).
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Kai-Lin Chen, Yan-Hui Liu and Wen-Yu Li contributed equally to this work.
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Chen, KL., Liu, YH., Li, WY. et al. The prognostic nutritional index predicts survival for patients with extranodal natural killer/T cell lymphoma, nasal type. Ann Hematol 94, 1389–1400 (2015). https://doi.org/10.1007/s00277-015-2361-8
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DOI: https://doi.org/10.1007/s00277-015-2361-8