The Nutritional Status of Patients with Diffuse Large B cell Lymphoma Does it Matter?

Background: Nutritional status of lymphoma is not routinely assessed. The aim of this study was to assess nutritional status at the beginning of the treatment and to evaluate its value as predictor of progression free survival. Methodology: This study embraced 77 male and 73 female patients with confirmed Non Hodgkin diffuse large B cell lymphoma, treatment naive, treated with R-CHOP in period November 2011 and June 2016. Previous revised international prognostic score (R-IPI) was taken into consideration. Nutritional status was assessed by using Nutritional risk score (NRS2002). New score was made by adding nutritional assessment. Results: In our group 81(54%) patients were over >60 years, 92(61.3%) had clinical stage ≥III, 61(40.7%) had elevated LDH, 79(52.7%) had Eastern Cooperative Oncology Group performance status (ECOG PS)≥2, extranodal disease was present in 60(40%). According to NRS2002 89(59.3%) had score ≥3, BMI≤20.5 kg/m2 23(14.7%) and 50(33.3%) had weight loss over 10% for past 6 months. Nutritional status was significantly different in patients with worse ECOG PS. Patients with NRS2002 score ≥5, identifying patients with severe malnutrition, had shorter PFS (Mean: 19.4 with 95%, CI: 8.23-29.88 months) than groups with normal (Mean: 56.7 with 95% CI: 52.2-61 months) or in risk of malnutrition (42.3 with 95%CI 34.4-50.3 months), p≤0.001. New IPI-NRS ≥4 can identify patients with short PFS. Conclusion: NRS 2002 assessment seems to be useful tool as a predictor of PFS in patients with diffuse large B cell lymphoma. Adding it to widely used IPI can we better predict the outcome.