[The Prognostic Value of Prognostic Nutritional Index Combined with D-dimer in Patients with Diffuse Large B-Cell Lymphoma].

Objective: To explore the effects of prognostic nutritional index (PNI) combined with D-dimer on the prognosis of patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL).

Methods: The clinical data of 73 DLBCL patients at initial diagnosis were retrospectively evaluated, and the optimal cut-off point of PNI and D-dimer were determined by ROC curve. The overall survival (OS) rate and progression-free survival (PFS) rate in different subgroups were compared using Kaplan-Meier survival curves. Univariate and multivariate Cox regression analysis was performed to identify the factors associated with OS.

Results: Compared with the low PNI group (PNI<44.775), the high PNI group (PNI≥44.775) had better OS ( =0.022) and PFS ( =0.029), the 2-year OS rates of the two groups were 55.6% and 78.3% respectively ( =0.041). Compared with the high D-dimer group (D-dimer≥0.835), the low D-dimer group (D-dimer<0.835) had better OS ( <0.001) and PFS ( <0.001), the 2-year OS rates of the two groups were 51.4% and 86.8% respectively ( =0.001). Meanwhile, patients in the high PNI+ low D-dimer group had better OS ( =0.003) and PFS ( <0.001) than the other three groups, the 2-year OS rate was statistically different from the other three groups ( <0.05). The multivariate analysis revealed that NCCN-IPI ( =2.083, 95% : 1.034-4.196, =0.040), PNI ( =0.267, 95% : 0.076-0.940, =0.040) and PNI+D-dimer ( =9.082, 95% : 1.329-62.079, =0.024) were the independent risk factors affecting OS in patients with DLBCL. Subgroup analysis showed that PNI, D-dimer, and PNI combined with D-dimer could improve the prognostic stratification in low and low-intermediate risk DLBCL patients.

Conclusion: High PNI, low D-dimer and combination of high PNI and low D-dimer at initial diagnosis suggest a better prognosis in DLBCL patients.