The Geriatric Nutritional Risk Index (GNRI) can be prescribed for use as an independent prognostic trademark for overall survival (OS) and progression-free survival (PFS) in patients with diffuse large B-cell lymphoma (DLBCL), according to a study published in the Journal of Nutrition and Cancer.

DLBCL is a common type of lymphoma, accounting for approximately 30% to 40% of all non-Hodgkin lymphomas in the adult population. It is reported that treatment protocol with rituximab associated with cyclophosphamide, vincristine, doxorubicin, and prednisone (R-CHOP) has shown fruitful results in over 50% of patients with advanced-stage DLBCL and over 70% of all patients.

Hence, recognizing low-cost and readily available spare prognostic options can help to better risk assessments, prognostic predictions, and treatment selection. 

Read more about DLBCL guidelines

Prior studies have used serum albumin and the ratio between the actual body weight and ideal body weight to determine GNRI, a nutritional evaluation tool, the authors noted. Only a few studies have reported the prognostic effect of GNRI in patients with DLBCL, they added.

The research team conducted this study to investigate whether GNRI can be used as a prognostic indicator in patients with DLBCL. The team analyzed the data of patients with DLBCL between 2008 and 2020 in Turkey. The study included 206 patients with DLBCL and distributed them into 2 GNRI groups based on their nutrition status.

The research team determined the GNRI cutoff value using ROC analysis. Moreover, OS, B symptoms, age, lactate dehydrogenase, infiltration of bone marrow, and the GNRI were determined as the prognostic factors for mortality and were analyzed using the univariate Cox regression. 

Study results suggested that the OS of the patients with DLBCL with a GNRI score 104.238 or less was considerably lower than that of patients with a GNRI score of 104.238 or more. Moreover, the PFS of the patients with a GNRI score of 104.238 or less was substantially lower than those with a GNRI score of 104.238 or more.

“Our study showed that clinicians can use the GNRI as an independent prognostic marker in DLBCL patients with simple blood tests and general body measurements,” the authors concluded.


Atas U, Sozel H, Iltar U, et al. The prognostic impact of pretreatment geriatric nutritional risk index in patients with diffuse large B-cell lymphoma. Nutr Cancer. Published online November 7, 2022. doi:10.1080/01635581.2022.2142248