Ozkan Sidika Gulkan, Avci Suna, Urusak Ada, Buyukyatikci Arif Ataberk, Ali Kimiaei, Safaei Seyedehtina, Altuntas Yuksel, Ozturkmen Yuksel Asli, Durak Zeynep Asli, Yildiz Mehmet Serdar, Ozkan Hasan Atilla
Division of Hematology, Department of Internal Medicine, Bahcesehir University Faculty of Medicine, Istanbul, Türkiye.
Department of Geriatric Medicine, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Türkiye.
Sisli Etfal Hastan Tip Bul. 2025 Mar 18;59(1):64-75. doi: 10.14744/SEMB.2025.74050. eCollection 2025.
Nutritional status significantly impacts outcomes in allogeneic hematopoietic stem cell transplantation (allo-HSCT). Among various indices, the Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) scores hold potential as prognostic tools. This study compares their predictive utility for transplant outcomes.
A retrospective analysis was conducted on 41 patients who underwent their first allo-HSCT between October 2022 and July 2024. Nutritional scores were calculated using pre-transplant data, and their associations with mortality and non-relapse mortality (NRM) were assessed. Receiver operating characteristic (ROC) curves and multivariable logistic regression were employed to evaluate predictive accuracy.
The high CONUT score demonstrated the highest prognostic accuracy for mortality (AUC: 0.771, p=0.026) and NRM (AUC: 0.806, p=0.047). It was the sole independent predictor of mortality (OR: 2.180, p=0.028). Both the NRI (AUC: 0.737, p=0.040) and PNI (AUC: 0.803, p=0.008) were also associated with mortality but lacked independent predictive value. Higher CONUT scores correlated with increased mortality rates.
The CONUT score emerged as the most effective nutritional scoring system for predicting mortality in allo-HSCT patients. Its simplicity and integration of key clinical parameters make it a valuable tool for early risk stratification and targeted interventions. Further studies with larger cohorts are warranted to validate these findings and refine nutritional management strategies.
营养状况对异基因造血干细胞移植（allo-HSCT）的结局有显著影响。在各种指标中，营养风险指数（NRI）、预后营养指数（PNI）和控制营养状况（CONUT）评分有望作为预后工具。本研究比较了它们对移植结局的预测效用。
对2022年10月至2024年7月期间接受首次allo-HSCT的41例患者进行回顾性分析。使用移植前数据计算营养评分，并评估其与死亡率和非复发死亡率（NRM）的相关性。采用受试者操作特征（ROC）曲线和多变量逻辑回归评估预测准确性。
高CONUT评分对死亡率（AUC：0.771，p=0.026）和NRM（AUC：0.806，p=0.047）显示出最高的预后准确性。它是死亡率的唯一独立预测因子（OR：2.180，p=0.028）。NRI（AUC：0.737，p=0.040）和PNI（AUC：0.803，p=0.008）也与死亡率相关，但缺乏独立预测价值。较高的CONUT评分与死亡率增加相关。
CONUT评分是预测allo-HSCT患者死亡率最有效的营养评分系统。其简单性和关键临床参数的整合使其成为早期风险分层和靶向干预的有价值工具。有必要进行更大队列的进一步研究以验证这些发现并完善营养管理策略。
