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The prognostic nutritional index predicts survival for patients with extranodal natural killer/T cell lymphoma, nasal type

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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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    Authors and Affiliations

    1. Department of Medical Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dong Feng RD East, Guangzhou, 510060, China

      Kai-Lin Chen, Wen-Qi Jiang, Hui-Qiang Huang, Tong-Yu Lin & Qing-Qing Cai

    2. Department of Pathology, Guangdong General Hospital, Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, China

      Yan-Hui Liu

    3. Division of Lymphoma, Cancer Center, Guangdong General Hospital, 123 Hui Fu RD West, Guangzhou, 510089, China

      Wen-Yu Li

    4. Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Radiotherapy Department, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, 510120, China

      Jie Chen

    5. Minimally Invasive and Interventional Department, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine, 651 Dong Feng RD East, Guangzhou, 510060, China

      Yang-Kui Gu

    6. Department of Hematology and Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine, 651 Dong Feng RD East, Guangzhou, 510060, China

      Qi-Rong Geng & Zhong-Jun Xia

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    Correspondence to Qing-Qing Cai.

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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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