Abstract:
Objective To explore the diagnostic value of the Global Leadership Initiative on Malnutrition (GLIM) criteria for malnutrition in patients with non-Hodgkin lymphoma (NHL) and to evaluate the relationship between malnutrition under the GLIM criteria and patient survival.
Methods A total of 157 newly diagnosed NHL patients who were admitted to Department of Hematology, the Second Affiliated Hospital of the Air Force Medical University between July 2020 and December 2021 were enrolled and their clinical data were collected. Their nutritional status was assessed using both the GLIM criteria and the Patient-Generated Subjective Global Assessment (PG-SGA) scale. Receiver Operating Characteristic (ROC) curves were plotted to evaluate the diagnostic efficiency of the GLIM criteria for malnutrition. Kaplan-Meier survival curves were plotted to analyze the survival outcomes of patients with different nutritional statuses under the GLIM criteria. The Cox proportional hazards regression model was employed to assess the impact of nutritional status based on GLIM criteria on patient prognosis.
Results Among the 157 newly diagnosed NHL patients, 107 (68.15%) were identified as being at risk of malnutrition (NRS 2002 scores ≥3). According to the GLIM criteria, the malnutrition rate was 42.68% (67/157), which was lower than 62.42% (98/157) identified by PG-SGA. The consistency between the GLIM criteria and PG-SGA in diagnosing malnutrition was moderate (Kappa=0.496,
P<0.001). The area under the ROC curve (AUC) was 0.77 (95%CI 0.71-0.83). The median follow-up time for the prognosis study was 33 months (1-39 months). The 2-year overall survival rates for the well-nourished group and the malnourished group under the GLIM criteria were 91.1% and 83.1%, respectively (
χ2=4.222,
P=0.040). The 2-year overall surivival rates for the severely malnourished group, moderately malnourished group, and well-nourished group were 81.7%, 84.5%, and 91.1%, respectively. A statistically significant difference in survival curves was observed between the severely malnourished group and the well-nourished group (
χ2=5.543,
P=0.019). The Cox proportional hazards model indicated that malnutrition under the GLIM criteria was an independent risk factor for overall survival in NHL patients (
P<0.05).
Conclusions The GLIM criteria can diagnose malnutrition and its severity in NHL patients, and can serve as a predictor of patient prognosis and survival.