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Prognostic impact of pretreatment skeletal muscle index and CONUT score in diffuse large B-cell Lymphomaopen access

Authors
Go, Se-IlChoi, Bong-HoiPark, Mi JungPark, SungwooKang, Myoung HeeKim, Hoon-GuKang, Jung HunJeong, Eun JeongLee, Gyeong-Won
Issue Date
Nov-2023
Publisher
BioMed Central Ltd
Keywords
Cachexia; Controlling nutritional status; Diffuse large B-cell; Lymphoma; Malnutrition; Sarcopenia
Citation
BMC Cancer, v.23, no.1
Indexed
SCIE
SCOPUS
Journal Title
BMC Cancer
Volume
23
Number
1
URI
https://scholarworks.gnu.ac.kr/handle/sw.gnu/68497
DOI
10.1186/s12885-023-11590-y
ISSN
1471-2407
Abstract
Background: Although the prognostic value of the Controlling Nutritional Status (CONUT) score in diffuse large B-cell lymphoma (DLBCL) has been reported in several previous studies, its clinical relevance for the presence of sarcopenia has not been assessed. Methods: In this study, 305 DLBCL patients were reviewed. They were categorized into normal/mild (n = 219) and moderate/severe (n = 86) CONUT groups. Sarcopenia was assessed using the L3-skeletal muscle index measured by baseline computed tomography imaging. Based on CONUT score and sarcopenia, patients were grouped: A (normal/mild CONUT and no sarcopenia), B (either moderate/severe CONUT or sarcopenia, but not both), and C (both moderate/severe CONUT and sarcopenia). Results: The moderate/severe CONUT group showed higher rates of ≥ grade 3 febrile neutropenia, thrombocytopenia, non-hematologic toxicities, and early treatment discontinuation not related to disease progression, compared to the normal/mild CONUT group. The moderate/severe CONUT group had a lower complete response rate (58.1% vs. 80.8%) and shorter median overall survival (18.5 vs. 162.6 months) than the normal/mild group. Group C had the poorest prognosis with a median survival of 8.6 months, while groups A and B showed better outcomes (not reached and 60.1 months, respectively). Combining CONUT score and sarcopenia improved the predictive accuracy of the Cox regression model (C-index: 0.763), compared to the performance of using either CONUT score (C-index: 0.754) or sarcopenia alone (C-index: 0.755). Conclusions: In conclusion, the moderate/severe CONUT group exhibited treatment intolerance, lower response, and poor prognosis. Additionally, combining CONUT score and sarcopenia enhanced predictive accuracy for survival outcomes compared to individual variables. © 2023, The Author(s).
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