Malnutrition and outcome in elderly patients (≥ 65 Jahre) with agressive Non-Hodgkin-Lymphoma

Both malnutrition and serum albumin (SA) have been shown to be independent negative predictors of impaired treatment response in many hematological malignancies. The body mass index (BMI) as an easily measurable value is part of many definitions of malnutrition. Here, the aim was firstly to investigate whether SA and BMI can be independent markers for malnutrition and secondly whether SA and BMI can be considered as independent prognostic factors in general for patients with newly diagnosed DLBCL treated mainly with rituximab, cyclophosphamide, vincristine, doxorubicin, and prednisone (RCHOP). Patients who presented at the University Medical Center Georg-August University, Göttingen from 2000 to 2017 for DLBCL diagnosis or treatment were identified using the institutional database. Clinical and treatment data were recorded, including SA levels and BMI at diagnosis. Survival time was estimated using the Kaplan-Meier method, with Cox regression analysis used to identify potential risk factors for time-to-event data. From 802 identified patients, 668 were excluded for not having primary treatment at our institution or not having complete data sets. In 134 included patients (mean age at diagnosis of 74 years), 26 % were categorized as poor by the International Prognostic Index and 42% had a low SA <3.5 mg/dl. Overall survival (OS) and progression-free survival (PFS) at 5 years were 79 % (95 % CI 0.71 - 0.87) and 64 % (95 % CI 0.56 - 0.74), respectively. While the first hypothesis with SA and BMI as markers for malnutrition had to be rejected, using multivariate analysis adjusted for IPI SA could be identified as an independent prognostic marker for OS and PFS with a hazard ratio of 3.98 (95 % CI 1.65 - 9.67) and 2.14 (95 % CI 1.16 - 4.11), respectively. Our study demonstrates that SA