Cetintepe Tugba, Cetintepe Lutfi, Unal Demet Kiper, Aygun Kemal, Solmaz Serife
Department of Hematology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey.
Department of Nephrology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey.
Medicine (Baltimore). 2025 May 30;104(22):e42165. doi: 10.1097/MD.0000000000042165.
Diffuse large B cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma. It is a heterogeneous group of diseases that may need very aggressive treatment in some cases. Prognostic evaluation is very important in determining the best treatment. However, in some clinics, access to genetically based and expensive diagnostic methods is limited. In this study, we analyzed the prognostic value of Hemoglobin, Albumin, Lymphocyte and Platelet (HALP) Score and Geriatric Nutritional Risk Index (GNRI) in DLBCL patients. 201 Patients with newly diagnosed DLBLC between 2005 and 2022 were retrospectively evaluated. Optimal cutoff points for the HALP score and the GNRI were calculated with the receiver operating characteristic curve analysis. Kaplan-Meier method was used to compare survival and disease-free survival times between HALP score groups. In the receiver operating characteristic curve analysis, the cutoff points were found 26.17 for HALP, and 99.17 for GNRI. Groups with lower HALP scores and lower GNRIs had significantly shorter overall survival and disease-free survival. Univariate analyses showed that lower HALP score, lower GNRI and higher lactic dehydrogenase, Ann-Arbor stage, International Prognostic Index (IPI), National Comprehensive Cancer Network-IPI and Revised-IPI scores were associated with worse survival rates (P < .05). According to the results of the multivariate Cox regression model, patients with HALP score ≤ 26.17 (OR: 2.32; 95%CI: 1.31-4.11 P = .004) increased the risk of death (P = .001, -2 loglikelihood = 506.15). Similarly, a GNRI score ≤ 99.17 was significantly correlated with worse survival outcomes (P < .001). HALP score and GNRI score are reliable, simple and easily accessible indices that can be used to predict the prognosis of DLBLC patients. DLBLC patients with low HALP score and low GNRI level may be associated with short survival and early nutritional support should be considered.
弥漫性大B细胞淋巴瘤（DLBCL）是非霍奇金淋巴瘤最常见的亚型。它是一组异质性疾病，在某些情况下可能需要非常积极的治疗。预后评估对于确定最佳治疗方案非常重要。然而，在一些诊所，基于基因的昂贵诊断方法的获取有限。在本研究中，我们分析了血红蛋白、白蛋白、淋巴细胞和血小板（HALP）评分以及老年营养风险指数（GNRI）在DLBCL患者中的预后价值。对2005年至2022年间新诊断的201例DLBLC患者进行了回顾性评估。通过受试者工作特征曲线分析计算HALP评分和GNRI的最佳截断点。采用Kaplan-Meier方法比较HALP评分组之间的生存时间和无病生存时间。在受试者工作特征曲线分析中，HALP的截断点为26.17，GNRI的截断点为99.17。HALP评分较低和GNRI较低的组的总生存期和无病生存期明显较短。单因素分析显示，较低的HALP评分、较低的GNRI以及较高的乳酸脱氢酶、Ann-Arbor分期、国际预后指数（IPI）、美国国立综合癌症网络-IPI和修订版-IPI评分与较差的生存率相关（P<0.05）。根据多变量Cox回归模型的结果，HALP评分≤26.17的患者（OR：2.32；95%CI：1.31-4.11，P = 0.004）死亡风险增加（P = 0.001，-2对数似然=506.15）。同样，GNRI评分≤99.17与较差的生存结果显著相关（P<0.001）。HALP评分和GNRI评分是可靠、简单且易于获取的指标，可用于预测DLBLC患者的预后。HALP评分低和GNRI水平低的DLBLC患者可能生存期较短，应考虑早期营养支持。
