Department of Hematology and Infectious Disease, Gifu University Hospital, Gifu, Japan.
Department of Hematology, Gifu Municipal Hospital, Gifu, Japan.
Leuk Lymphoma. 2024 Mar;65(3):339-345. doi: 10.1080/10428194.2023.2295787. Epub 2023 Dec 20.
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, = 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 ( = 0.71 for interaction). Further, the CONUT score independently affected initial dose intensity (odds ratio 0.84, 95% CI 0.73-0.95, = 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.
预测预后对于年龄较大的弥漫性大 B 细胞淋巴瘤 (DLBCL) 患者至关重要。本研究通过回顾性队列研究评估了控制营养状况 (CONUT) 评分（一种简单的营养指数）对接受 R-CHOP 样方案治疗的老年 DLBCL 患者（≥65 岁）的预后影响，共纳入 203 例患者。CONUT 评分是多变量 Cox 比例风险模型中总生存期的独立预后因素（风险比 1.11，95%置信区间 1.01-1.21， = 0.032）。在接受者操作特征分析中，最佳截断值为 3。CONUT 评分（≥3 或 <3）可有效分层老年 DLBCL 患者，与国际预后指数无关（交互作用 = 0.71）。此外，CONUT 评分独立影响初始剂量强度（比值比 0.84，95%置信区间 0.73-0.95， = 0.008），这可能反映了患者在诊断时的状态，并影响剂量调整。总之，CONUT 评分与老年 DLBCL 患者的不良预后相关。
