Infection and Drug Resistance (Mar 2021)
The Value of Nutritional Status in the Prognostic Analysis of Patients with AIDS-Related Lymphoma
Abstract
Yanbo Sun,1,* Jing Luo,2,* Chuan Qian,3,* Lan Luo,3 Manqi Xu,1 Haiyan Min,3 Yunyun Cen1 1Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, 650101, People’s Republic of China; 2Department of Gastrointestinal Surgery, The First People’s Hospital of Qujing, Qujing, 655000, People’s Republic of China; 3The Second Department of Infection, Yunnan Provincial Infectious Disease Hospital, Kunming, 650301, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yunyun CenDepartment of Gastrointestinal Surgery, The Second Affiliated Hospital of Kunming Medical University, No. 374 of Yunnan-Burma Road, Kunming City, Yunnan Province, 650101, People’s Republic of ChinaTel +86-871-63402778Fax +86-871-65361017Email [email protected] MinThe Second Department of Infection, Yunnan Provincial Infectious Disease Hospital, Shi’an Highway in Kunming, Kunming City, Kunming, Yunnan Province, 650301, People’s Republic of ChinaTel/Fax +86-871-68728053Email [email protected]: Many studies have suggested that indexes of nutritional status, such as body mass index (BMI), serum albumin (ALB), serum pre-albumin (PA), and hemoglobin, may be used as risk factors for the prognosis of HIV or lymphoma. Therefore, this study aimed to retrospectively analyze and explore the value of nutritional status in the prognostic assessment of patients with AIDS-related lymphoma (ARL).Methods: In this retrospective study, the clinical data of 69 patients with ARL were collected. All patients had a definite diagnosis of non-Hodgkin lymphoma by pathological examination and met the requirements of the Hematopoietic and Lymphocytic Tissue Tumor Classification (2016) established by the World Health Organization. Patients who did not receive standard chemotherapy, those with incomplete medical records, and those with an unclear pathological diagnosis were excluded. The patients were divided into two groups (survival and death) according to the prognostic outcome, and their clinical characteristics and prognoses were discussed by relevant statistical methods.Results: During the three-year follow-up period, 20 (28.99%) patients died, and 49 (71.01%) survived. The one-year cumulative survival rate was 78.26%. A univariate analysis found that the prognosis was associated with the International Prognostic Index (IPI) score, BMI, ALB, PA, and CD4 T lymphocyte count. The Cox risk proportional regression analysis showed that the IPI score, BMI, and PA were the independent risk factors for survival; their combination had a greater ability to forecast the clinical outcome (area under the curve = 0.874, P < 0.001).Conclusion: In this study, at the time of the visit, the patients with ARL tended to be in the advanced stages of disease and, therefore, at high risk of mortality. Therefore, their nutritional status might be of great value to the prognostic assessment. The combination of BMI, PA, and IPI scores could be used for risk stratification and better screening of high-risk patients.Keywords: AIDS-related lymphoma, body mass index, pre-albumin, prognostic factor, retrospective analysis
