The Prognostic Impact of Comorbidity, Nutritional and Performance Status on Patients with Diffuse Large B Cell Lymphoma

Abstract

Background: The aim of the study was to investigate the impact of nutritional status, comorbidity, and performance status on patients  with diffuse large B‑cell lymphoma (DLBCL). 

Methods: A retrospective study was conducted on 112 DLBCL patients who were diagnosed  at our center between 2009 and 2018. Demographic and disease characteristics and laboratory test results were recorded. Assessments  were made using the age‑adjusted Charlson comorbidity index (CCI‑A) for comorbidity, albumin level for nutritional status, and Eastern  Cooperative Oncology Group (ECOG) score for performance status. 

Results: The mean age of the patients was found to be 62.63 ± 15.16  years. The ECOG score of 65 patients (69.1%) was in the range of 0–1. The mean follow‑up time of the patients was determined to be  25.24 ± 25.11 months, and at the end of the follow‑up period, 64 patients (57.1%) were survivors. The progression‑free survival (PFS),  overall survival (OS), and 5‑year OS rates of those with CCI‑A > 4 were found to be significantly lower than those with CCI‑A score ≤4 (P <  0.05). As a result of the Cox‑Regression (Backward: LR method) analysis, ECOG and albumin levels were found to be independent risk  factors for both OS and PFS (P < 0.05). 

Conclusion: This study demonstrated that CCI‑A, ECOG, and nutritional status are independent  prognostic markers for DLBCL patients. Initial evaluation of these patients should include all these parameters, which are easily available  at the time of diagnosis.