ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1591508
This article is part of the Research TopicNutrition in Cancer Patients Undergoing Targeted Therapy: From Mechanisms to Clinical PracticeView all 5 articles
Nutritional and Immune-Inflammatory Scoring System for Predicting Outcomes in Newly Diagnosed Diffuse Large B-Cell Lymphoma Patients
Provisionally accepted
Yu Peng1
Tingting Jiang1
Shuang Chen1
Xinyi Tang2
Yakun Zhang2
Liangmei Li1
Lian Li1
Longrong Ran1Xuelian Wu1
Jun Li1
Wei Zhang1
Nanjun Li1
Zailin Yang1
Yao Liu1*- 1Cancer Hospital, Chongqing University, Chongqing, China
- 2School of Medicine, Chongqing University, Chongqing, Chongqing Municipality, China
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Diffuse large B-cell lymphoma (DLBCL), the most common aggressive non-Hodgkin lymphoma, typically has a poor prognosis. Currently, the International Prognostic Index (IPI) and National Comprehensive Cancer Network (NCCN)-IPI prognostic scoring systems for DLBCL patients do not account for the impact of patients' nutritional, immune, and inflammatory responses on their prognosis. We developed a prognostic scoring system for DLBCL patients based on easily obtainable or measurable nutritional, immune, and inflammatory indicators to complement and improve the existing NCCN-IPI and IPI systems. This study developed the nutritional and immune-inflammatory scoring system (NII), including Nutritional Risk Screening (NRS2002), Geriatric Nutritional Risk Index (GNRI), systemic immune-inflammation index (SII), lactic dehydrogenase to albumin ratio (LAR), β2-microglobulin (β2-MG), and CD8+ T cells. A high NII (≥ 6) effectively identifies high-risk DLBCL patients and serves as an independent prognostic factor beyond other clinical characteristic, IPI, and NCCN-IPI. DLBCL patients with a high NII (≥ 6) exhibit significantly adverse clinical features, including older age, lower frequency of the non-GCB subtype, advanced Ann Arbor stage (III/IV), poor performance status (ECOG PS ≥ 2), involvement of ≥ 2 extranodal sites, presence of B symptoms, elevated lactate dehydrogenase (LDH) levels, and classification into higher-risk groups according to IPI and NCCN-IPI. Combining NII with IPI or NCCN-IPI significantly improves the assessment of patient prognosis compared to using IPI or NCCN-IPI alone.
Keywords: Key word：DLBCL, nutritional, immune, Inflammatory, Score system
Received: 13 Mar 2025; Accepted: 09 Jul 2025.
Copyright: © 2025 Peng, Jiang, Chen, Tang, Zhang, Li, Li, Ran, Wu, Li, Zhang, Li, Yang and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yao Liu, Cancer Hospital, Chongqing University, Chongqing, China
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