Prognostic value of BMI, prognostic nutritional index, and CRP in patients with lymphoma after autologous hematopoietic stem cell transplantation.

[OBJECTIVE] Analyze the predictive value of body mass index (BMI), prognostic nutritional index (PNI), C-reactive protein (CRP), and CD3+CD8+T for the prognosis of lymphoma patients undergoing autologous hematopoietic stem cell transplantation.

[METHOD] We retrospectively included 160 patients with malignant lymphoma who underwent first-line or salvage chemotherapy and successfully underwent autologous hematopoietic stem cell transplantation in our hospital between May 2010 and January 2019. The clinical data of the patients before transplantation (baseline period) were collected and analyzed. The cutoff values were obtained based on the ROC curve. The clinical characteristics of patients were compared, including age, gender, physical condition (ECOG PS) score, Ann Arbor staging, International Prognostic Index (IPI) score, extranodal involvement, bone marrow involvement, and B symptoms. Followed up for 5 years, Kaplan-Meier method and Cox proportional hazards regression model were used to analyze the effects of various indicators and clinical characteristics on overall survival (OS) and progression-free survival (PFS).

[RESULT] According to the ROC curve cutoff value, 160 patients were divided into low BMI group (83 cases) and high BMI group (77 cases), low PNI group (78 cases) and high PNI group (82 cases), low CRP group (90 cases) and high CRP group (70 cases), low CD3+CD8+T group (86 cases) and high CD3+CD8+T group (74 cases). There were significant differences in ECOG PS score, Ann Arbor staging, IPI score, and B symptoms among patients with different BMI levels (P < 0.05). There were differences in ECOG PS score, Ann Arbor staging, and IPI score among patients with different PNI levels (P < 0.05). Patients with different CRP levels also have differences in ECOG PS score, Ann Arbor staging, IPI score, spinal cord involvement, and B symptoms (P < 0.05). A total of 160 lymphoma patients were followed up for 5 years, with a survival rate of 65.00% (104/160). Kaplan-Meier analysis showed that low BMI, low PNI, high CRP, and high CD3+CD8+T were all associated with poorer overall survival and progression-free survival (P < 0.05). Multivariate Cox regression analysis showed that low PNI and high CRP were independent risk factors for both OS and PFS. In addition, Ann Arbor staging (stages III-IV) was an independent risk factor for OS and PFS, but high CD3+CD8+T was an independent risk factor for PFS.

[CONCLUSION] Low levels of PNI and CRP before transplantation are independent risk factors affecting overall survival and progression-free survival in lymphoma patients undergoing autologous hematopoietic stem cell transplantation. In addition, high levels of CD3+CD8+T cells are an independent risk factor for progression-free survival. These indicators provide new and valuable reference for clinical doctors to more accurately evaluate patient prognosis.