Relationship between Low Pretreatment Geriatric Nutritional Risk Index and Poor Tolerability of Azacitidine in Patients with Myelodysplastic Syndromes
Relationship between Low Pretreatment Geriatric Nutritional Risk Index and Poor Tolerability of Azacitidine in Patients with Myelodysplastic Syndromes
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骨髓增生异常综合征患者治疗前低老年营养风险指数与阿扎胞苷不良耐受性的关系
DOI：
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发表时间：
2021
影响因子：
3.9
通讯作者：
Tetsuro Yumoto
中科院分区：
文献类型：
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作者：
Dan Kanehira;M. Koinuma;T. Kato;Tomoya Abe;A. Sagara;Fumiaki Sato;Tetsuro Yumoto
背景资料：在骨髓增生异常综合征（MDS）患者开始治疗前，预测阿扎胞苷（AZA）的耐受性和治疗相关风险是进行适当治疗的必要条件。因此，在本研究中，使用老年营养风险指数（GNRI）评估AZA治疗前MDS患者的营养状况。还研究了AZA开始后的耐受性和总生存期（OS）。方法：这是一项单中心回顾性观察研究。共59例接受AZA治疗的MDS患者使用GNRI进行评估，并对营养不良（GNRI <92，n = 27）和非营养不良（GNRI ≥92，n = 32）患者进行比较。结果如下：与非营养不良组相比，营养不良组成功完成4个周期AZA治疗的患者数量显著减少（营养不良组，11/27例患者，40.7% vs.非营养不良组，24/32例患者，75.0%; p = 0.009）。与差异相关的因素包括核型和GNRI。与非营养不良组相比，营养不良组的感染并发症发生率也显著增加（营养不良组，33/60个周期，55.0% vs.非营养不良组，31/92个周期，33.7%; p = 0.012）。最后，与非营养不良组相比，营养不良组的OS显著降低（营养不良组，11.5个月; 95% CI，5.2-16.7 vs.非营养不良组，21.9个月; 95% CI，13.8-24.0; p = 0.026）。与OS相关的因素包括修订的国际预后评分系统（IPSS-R）和GNRI。结论：这些结果表明，在MDS患者接受AZA治疗前预测治疗完成情况和不良事件是重要的。这项研究表明，GNRI可能是一个有价值的营养评估工具，用于确定耐受性和OS的AZA治疗。
Background: Predicting tolerability and treatment-related risks associated with azacitidine (AZA) in patients with myelodysplastic syndromes (MDS) before the initiation of therapy is required for appropriate treatment. Thus, in this study, the nutritional status of patients with MDS prior to AZA treatment was evaluated using the geriatric nutritional risk index (GNRI). Tolerability and overall survival (OS) after AZA initiation were also investigated. Methods: This was a single-center retrospective observational study. A total of 59 patients with MDS treated with AZA were assessed using GNRI, and a comparison of undernourished (GNRI <92, n = 27) and non-undernourished (GNRI ≥92, n = 32) patients was performed. Results: The undernourished group had a significant reduction in the number of patients that successfully completed 4 cycles of AZA treatment compared with the non-undernourished group (undernourished group, 11/27 patients, 40.7% vs. non-undernourished group, 24/32 patients, 75.0%; p = 0.009). Factors associated with the difference included karyotype and GNRI. There was also a significant increase in the rate of infectious complications in the undernourished group compared with the non-undernourished group (undernourished group, 33/60 cycles, 55.0% vs. non-undernourished group, 31/92 cycles, 33.7%; p = 0.012). Lastly, a significant reduction in OS was observed in the undernourished group compared with the non-undernourished group (undernourished group, 11.5 months; 95% CI, 5.2–16.7 vs. non-undernourished group, 21.9 months; 95% CI, 13.8–24.0; p = 0.026). Factors associated with OS included both the revised International Prognostic Scoring System (IPSS-R) and GNRI. Conclusions: These results indicate that predicting treatment completion and adverse events in patients with MDS prior to AZA treatment is important. This study suggests GNRI may be a valuable nutritional assessment tool for determining tolerability and OS of AZA treatment.
与常规护理方案相比，阿扎西丁氨酸的疗效在治疗高风险的髓质发育异常综合征中：一项随机，开放标签的III期研究。
影响因子：
51.1
作者：
Fenaux, Pierre;Mufti, Ghulam J.;Hellstrom-Lindberg, Eva;Santini, Valeria;Finelli, Carlo;Giagounidis, Aristoteles;Schoch, Robert;Gattermann, Norbert;Sanz, Guillermo;List, Alan;Gore, Steven D.;Seymour, John F.;Bennett, John M.;Byrd, John;Backstrom, Jay;Zimmerman, Linda;McKenzie, David;Beach, C. L.;Silverman, Lewis R.
通讯作者：
Silverman, Lewis R.