Lower Body Mass Index and Prognostic Nutritional Index Are Associated With Poor Post-transplant Outcomes in Lymphoma Patients Undergoing Autologous Stem Cell Transplantation

Background: Pre-transplant inflammatory and nutritional status has not been widely explored in terms of its impact on autologous hematopoietic stem cell transplantation (auto-HSCT) outcomes in lymphoma patients. We aimed to evaluate the impact of body mass index (BMI), prognostic nutri-tional index (PNI), and C-reactive protein to albumin ratio (CAR) on auto-HSCT outcomes. Meth-od: We retrospectively analyzed 87 consecutive lymphoma patients who underwent their first auto-HSCT at the Adult Hematopoietic Stem Cell Transplantation Unit at Akdeniz University Hospital. Result: CAR had no impact on post-transplant outcomes. PNI & LE;50 was an independent prognostic factor for both shorter progression free survival (PFS) (hazard ratio [HR]=2.43, P = .025) and worse overall survival (OS) (HR=2.93, P = .021), respectively. The 5-year PFS rate was significantly lower in patients with PNI & LE;50 than in patients with PNI>50 (37.3% vs. 59.9%, P = .003). The 5-year OS rate in patients with PNI & LE;50 had significantly low when compared with patients who had PNI>50 as well (45.5% vs. 67.2%, P = .011). Patients with BMI<25 had higher 100-day TRM compared with patients with BMI & GE;25 (14.7% vs 1.9%, P = .020). BMI<25 was an independent prognostic factor associated with shorter PFS and OS (HR=2.98, P = .003, HR=5.06, P < .001, respectively). The 5-year PFS rate was significantly lower in patients with BMI<25 than patients with BMI & GE;25 (40.2% vs. 53.7%, P = .037). Similarly, the 5-year OS rate in patients with BMI<25 had significant-ly inferior compared to patients with BMI & GE;25 (42.7% vs. 64.7%, P = .002).Conclusion: Our study confirms that lower BMI and CAR have negative impacts on auto-HSCT outcomes in lymphoma patients. Furthermore, higher BMI should not be considered an obstacle for lymphoma patients who need auto-HSCT, conversely, it could be an advantage for post-transplant outcomes. Keywords: Lymphoma, autologous hematopoietic stem cell transplantation, body mass index, prognostic nutritional index