Prognostic role of prognostic nutritional index in patients with lymphoma-associated hemophagocytic lymphohistiocytosis.

AIMS

Lymphoma-associated hemophagocytic lymphohistiocytosis (LA-HLH) is a rare and life-threatening disorder. While the prognostic nutritional index (PNI) has been recognized as an independent prognostic indicator in lymphoma studies, its specific role in LA-HLH has not yet been reported.

METHODS

We retrospectively examined clinical characteristics and prognostic factors from 124 LA-HLH patients.

RESULTS

23 patients (18.5%) had B-cell lymphoma-associated HLH (B-LA-HLH), and 101 cases presented with T or natural killer (NK)-cell lymphoma-associated HLH (T/NK-LA-HLH). The median survival time for the entire group was two months, with T/NK-LA-HLH and B-LA-HLH showing median survival times of 1.6 months and 5.0 months, respectively, post-HLH diagnosis. The optimal threshold for the prognostic nutritional index (PNI) was 35.5. Analysis of prognostic factors indicated that the HLH onset at lymphoma relapse and a PNI below 35.5 were independent predictors of inferior overall survival. Patients with a PNI below 35.5 had a significantly shorter estimated survival duration than those with a PNI of 35.5 or higher ( = 0.003).

CONCLUSIONS

The onset of HLH at lymphoma relapse and a low PNI may be considered adverse prognostic indicators for LA-HLH, potentially aiding in risk stratification and informing clinical decisions.