Influence of Geriatric Nutritional Risk Index on Occurrence of Adverse Events and Duration of Treatment in Patients With Lymphoma Receiving R-CHOP Therapy

• Published in: In vivo (Athens) Vol. 37; no. 3; pp. 1297 - 1303
• Main Authors: Kikuchi, Ken, Sawada, Momoka, Takeda, Genki, Watanabe, Taiki, Souma, Takafumi, Sato, Hideki
• Format: Journal Article
• Language: English
• Published: Greece International Institute of Anticancer Research 01.05.2023
• Subjects: Aged; Antibodies, Monoclonal, Murine-Derived - adverse effects; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Cyclophosphamide - adverse effects; Doxorubicin - adverse effects; Duration of Therapy; Humans; Lymphoma, Large B-Cell, Diffuse - drug therapy; Prednisone - adverse effects; Rituximab - adverse effects; Vincristine - adverse effects; Malignant lymphoma; R-CHOP; Geriatric Nutritional Risk Index; time to treatment failure
• ISSN: 0258-851X; 1791-7549
• DOI: 10.21873/invivo.13208

No studies have examined the association between the Geriatric Nutritional Risk Index (GNRI) at the initiation of chemotherapy for malignant lymphoma and the occurrence of adverse events. Therefore, we investigated the impact of GNRI at treatment initiation on the occurrence of side effects and time to treatment failure (TTF) in patients with malignant lymphoma undergoing initial rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) therapy. This study included 131 patients who underwent initial R-CHOP therapy between March 2016 and October 2021. Patients were stratified into those with high (GNRI ≥92; n=56) or low (GNRI <92; n=75) GNRI status. Comparing the High GNRI group and Low GNRI group, the incidence of febrile neutropenia (FN) and Grade ≥3 creatinine increase, alkaline phosphatase (ALP) increase, albumin decrease, hemoglobin decrease, neutropenia, and thrombocytopenia were significantly higher in the Low GNRI group. TTF in the High GNRI group was significantly longer than that in the Low GNRI group (p=0.045). Multivariate analysis showed that the factors influencing the duration of treatment were PS (≥2) at the start of treatment, serum albumin level, and GNRI. In patients undergoing R-CHOP therapy, GNRI <92 at regimen initiation increased the risks of developing FN and hematologic toxicity. Multivariate analysis revealed that performance status, albumin levels, and GNRI at regimen initiation were the factors influencing treatment duration. Nutritional status at treatment initiation may influence the development of hematologic toxicity and TTF.