Geriatric nutritional risk index as a useful prognostic factor in second allogeneic hematopoietic stem cell transplantation
Second allogeneic hematopoietic stem cell transplantation (allo-HSCT) has a low survival outcome and a high non-relapse mortality (NRM) rate which is a major obstacle to this treatment. We hypothesized that the status of malnourishment after first allo-HSCT as represented by the geriatric nutritiona...
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| Veröffentlicht in: | Annals of hematology 2020-07, Vol.99 (7), p.1655-1665 |
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| creator | Kaito, Satoshi Wada, Atsushi Adachi, Hiroto Konuma, Ryosuke Kishida, Yuya Nagata, Akihito Konishi, Tatsuya Yamada, Yuta Kumagai, Takuma Yoshifuji, Kota Mukae, Junichi Akiyama, Megumi Inamoto, Kyoko Toya, Takashi Igarashi, Aiko Najima, Yuho Muto, Hideharu Kobayashi, Takeshi Kakihana, Kazuhiko Ohashi, Kazuteru Sakamaki, Hisashi Doki, Noriko |
| description | Second allogeneic hematopoietic stem cell transplantation (allo-HSCT) has a low survival outcome and a high non-relapse mortality (NRM) rate which is a major obstacle to this treatment. We hypothesized that the status of malnourishment after first allo-HSCT as represented by the geriatric nutritional risk index (GNRI) could be used as a prognostic factor to determine the outcomes of second allo-HSCT. A total of 108 patients with a median age of 42 (range, 17–69) years, who received second allo-HSCT for disease recurrence after first allo-HSCT from our institution, were included in this study. Low GNRI had a significant impact on NRM at 2 years after second allo-HSCT: 56.9% in patients with GNRI ≤ 92 compared with 27.5% in patients with GNRI > 92 (
P
= 0.002). In multivariate analysis, GNRI of ≤ 92 was the only significant factor for NRM (hazard ratio [HR] 2.29, 95% confidence interval [CI] 1.15–4.56,
P
= 0.018). High-risk disease status at second allo-HSCT (HR 2.74, 95% CI 1.46–5.14,
P
= 0.002) and GNRI of ≤ 92 (HR 1.70, 95% CI 1.02–2.82,
P
= 0.042) were identified as significant factors for overall survival (OS). A score of 1 was assigned to each factor, and the OS rate at 2 years after second allo-HSCT decreased according to the score: 53.0% in patients with score 0, 32.3% with score 1, and 2.5% with score 2 (
P
|
| doi_str_mv | 10.1007/s00277-020-04089-0 |
| format | Article |
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P
= 0.002). In multivariate analysis, GNRI of ≤ 92 was the only significant factor for NRM (hazard ratio [HR] 2.29, 95% confidence interval [CI] 1.15–4.56,
P
= 0.018). High-risk disease status at second allo-HSCT (HR 2.74, 95% CI 1.46–5.14,
P
= 0.002) and GNRI of ≤ 92 (HR 1.70, 95% CI 1.02–2.82,
P
= 0.042) were identified as significant factors for overall survival (OS). A score of 1 was assigned to each factor, and the OS rate at 2 years after second allo-HSCT decreased according to the score: 53.0% in patients with score 0, 32.3% with score 1, and 2.5% with score 2 (
P
< 0.001). In conclusion, GNRI could be a useful predictor for the outcomes of second allo-HSCT. A prospective study in other cohorts is warranted to validate the findings of our study.</description><identifier>ISSN: 0939-5555</identifier><identifier>EISSN: 1432-0584</identifier><identifier>DOI: 10.1007/s00277-020-04089-0</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Geriatrics ; Hematology ; Medical prognosis ; Medicine ; Medicine & Public Health ; Oncology ; Original Article ; Stem cell transplantation ; Stem cells</subject><ispartof>Annals of hematology, 2020-07, Vol.99 (7), p.1655-1665</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020</rights><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c352t-6c84a6b087352cd5ce2e679b0e2c0f19a26227c7e7b8238637f0aeef5a0751363</citedby><cites>FETCH-LOGICAL-c352t-6c84a6b087352cd5ce2e679b0e2c0f19a26227c7e7b8238637f0aeef5a0751363</cites><orcidid>0000-0002-8661-3179</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00277-020-04089-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00277-020-04089-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids></links><search><creatorcontrib>Kaito, Satoshi</creatorcontrib><creatorcontrib>Wada, Atsushi</creatorcontrib><creatorcontrib>Adachi, Hiroto</creatorcontrib><creatorcontrib>Konuma, Ryosuke</creatorcontrib><creatorcontrib>Kishida, Yuya</creatorcontrib><creatorcontrib>Nagata, Akihito</creatorcontrib><creatorcontrib>Konishi, Tatsuya</creatorcontrib><creatorcontrib>Yamada, Yuta</creatorcontrib><creatorcontrib>Kumagai, Takuma</creatorcontrib><creatorcontrib>Yoshifuji, Kota</creatorcontrib><creatorcontrib>Mukae, Junichi</creatorcontrib><creatorcontrib>Akiyama, Megumi</creatorcontrib><creatorcontrib>Inamoto, Kyoko</creatorcontrib><creatorcontrib>Toya, Takashi</creatorcontrib><creatorcontrib>Igarashi, Aiko</creatorcontrib><creatorcontrib>Najima, Yuho</creatorcontrib><creatorcontrib>Muto, Hideharu</creatorcontrib><creatorcontrib>Kobayashi, Takeshi</creatorcontrib><creatorcontrib>Kakihana, Kazuhiko</creatorcontrib><creatorcontrib>Ohashi, Kazuteru</creatorcontrib><creatorcontrib>Sakamaki, Hisashi</creatorcontrib><creatorcontrib>Doki, Noriko</creatorcontrib><title>Geriatric nutritional risk index as a useful prognostic factor in second allogeneic hematopoietic stem cell transplantation</title><title>Annals of hematology</title><addtitle>Ann Hematol</addtitle><description>Second allogeneic hematopoietic stem cell transplantation (allo-HSCT) has a low survival outcome and a high non-relapse mortality (NRM) rate which is a major obstacle to this treatment. We hypothesized that the status of malnourishment after first allo-HSCT as represented by the geriatric nutritional risk index (GNRI) could be used as a prognostic factor to determine the outcomes of second allo-HSCT. A total of 108 patients with a median age of 42 (range, 17–69) years, who received second allo-HSCT for disease recurrence after first allo-HSCT from our institution, were included in this study. Low GNRI had a significant impact on NRM at 2 years after second allo-HSCT: 56.9% in patients with GNRI ≤ 92 compared with 27.5% in patients with GNRI > 92 (
P
= 0.002). In multivariate analysis, GNRI of ≤ 92 was the only significant factor for NRM (hazard ratio [HR] 2.29, 95% confidence interval [CI] 1.15–4.56,
P
= 0.018). High-risk disease status at second allo-HSCT (HR 2.74, 95% CI 1.46–5.14,
P
= 0.002) and GNRI of ≤ 92 (HR 1.70, 95% CI 1.02–2.82,
P
= 0.042) were identified as significant factors for overall survival (OS). A score of 1 was assigned to each factor, and the OS rate at 2 years after second allo-HSCT decreased according to the score: 53.0% in patients with score 0, 32.3% with score 1, and 2.5% with score 2 (
P
< 0.001). In conclusion, GNRI could be a useful predictor for the outcomes of second allo-HSCT. A prospective study in other cohorts is warranted to validate the findings of our study.</description><subject>Geriatrics</subject><subject>Hematology</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Stem cell transplantation</subject><subject>Stem cells</subject><issn>0939-5555</issn><issn>1432-0584</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp9kU1rHDEMhk1podu0f6AnQy-5TCtrPjxzDCFNC4Fe2rPRejXbSWftjeWBhPz5eLKBQg_VRQg9ryT0KvXRwGcDYL8IAFpbAUIFDfRDBa_UxjQ1VtD2zWu1gaEeqrbEW_VO5BbAYN_gRj1ec5oop8nrsJSUpxho1mmSP3oKO77XJJr0Ijwusz6muA9RcqFH8jmmwmhhH8NO0zzHPQcuvd98oByPceKVlMwH7XmedU4U5DhTyLTuea_ejDQLf3jJZ-rX16ufl9-qmx_X3y8vbipft5irzvcNdVvobSn9rvWM3NlhC4weRjMQdojWW7bbHuu-q-0IxDy2BLY1dVefqfPT3HL-3cKS3WGS9SAKHBdx2BhEhMa2Bf30D3obl1Q-8kxZ09m-XSk8UT5FkcSjO6bpQOnBGXCrH-7khyt-uGc_HBRRfRJJgcOe09_R_1E9AeJej34</recordid><startdate>20200701</startdate><enddate>20200701</enddate><creator>Kaito, Satoshi</creator><creator>Wada, Atsushi</creator><creator>Adachi, Hiroto</creator><creator>Konuma, Ryosuke</creator><creator>Kishida, Yuya</creator><creator>Nagata, Akihito</creator><creator>Konishi, Tatsuya</creator><creator>Yamada, Yuta</creator><creator>Kumagai, Takuma</creator><creator>Yoshifuji, Kota</creator><creator>Mukae, Junichi</creator><creator>Akiyama, Megumi</creator><creator>Inamoto, Kyoko</creator><creator>Toya, Takashi</creator><creator>Igarashi, Aiko</creator><creator>Najima, Yuho</creator><creator>Muto, Hideharu</creator><creator>Kobayashi, Takeshi</creator><creator>Kakihana, Kazuhiko</creator><creator>Ohashi, Kazuteru</creator><creator>Sakamaki, Hisashi</creator><creator>Doki, Noriko</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8661-3179</orcidid></search><sort><creationdate>20200701</creationdate><title>Geriatric nutritional risk index as a useful prognostic factor in second allogeneic hematopoietic stem cell transplantation</title><author>Kaito, Satoshi ; 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We hypothesized that the status of malnourishment after first allo-HSCT as represented by the geriatric nutritional risk index (GNRI) could be used as a prognostic factor to determine the outcomes of second allo-HSCT. A total of 108 patients with a median age of 42 (range, 17–69) years, who received second allo-HSCT for disease recurrence after first allo-HSCT from our institution, were included in this study. Low GNRI had a significant impact on NRM at 2 years after second allo-HSCT: 56.9% in patients with GNRI ≤ 92 compared with 27.5% in patients with GNRI > 92 (
P
= 0.002). In multivariate analysis, GNRI of ≤ 92 was the only significant factor for NRM (hazard ratio [HR] 2.29, 95% confidence interval [CI] 1.15–4.56,
P
= 0.018). High-risk disease status at second allo-HSCT (HR 2.74, 95% CI 1.46–5.14,
P
= 0.002) and GNRI of ≤ 92 (HR 1.70, 95% CI 1.02–2.82,
P
= 0.042) were identified as significant factors for overall survival (OS). A score of 1 was assigned to each factor, and the OS rate at 2 years after second allo-HSCT decreased according to the score: 53.0% in patients with score 0, 32.3% with score 1, and 2.5% with score 2 (
P
< 0.001). In conclusion, GNRI could be a useful predictor for the outcomes of second allo-HSCT. A prospective study in other cohorts is warranted to validate the findings of our study.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><doi>10.1007/s00277-020-04089-0</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-8661-3179</orcidid></addata></record> |
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| subjects | Geriatrics Hematology Medical prognosis Medicine Medicine & Public Health Oncology Original Article Stem cell transplantation Stem cells |
| title | Geriatric nutritional risk index as a useful prognostic factor in second allogeneic hematopoietic stem cell transplantation |
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