ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1605421
This article is part of the Research TopicNutritional Impacts on Human Tumor Development and Immune SystemView all 16 articles
Association Between Prognostic Nutritional Index and Myelosuppression in Gastric Cancer Patients Undergoing Chemotherapy: A Retrospective Cohort Study
Provisionally accepted
- 1The First People's Hospital of Changde City, Changde, China
- 2Hunan Cancer Hospital, Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China
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Objective To investigate the association between Prognostic Nutritional Index (PNI) and chemotherapy-induced myelosuppression in gastric cancer patients. Methods This retrospective cohort study analyzed 562 gastric cancer patients receiving chemotherapy at two Chinese medical centers from January 2022 to December 2024. The exposure variable was PNI, calculated from serum albumin and lymphocyte count. The primary outcome was myelosuppression after the first chemotherapy cycle, defined according to CTCAE 5.0 criteria. Multiple logistic regression models adjusted for demographics, health status, tumor characteristics, treatment factors, and laboratory parameters. Results Myelosuppression occurred in 75.1% of patients. After full adjustment, each one-unit increase in PNI reduced myelosuppression risk by 13% (OR=0.87, 95%CI:0.79-0.96, p=0.004). Patients with PNI≤48 had a significantly higher risk of myelosuppression (OR=14.50, 95%CI:4.93-42.65, p<0.001). Significant effect modification was observed by sex (interaction p<0.001), with stronger protective effects in males (OR=0.71, 95%CI:0.60-0.84). Conclusion PNI is an independent predictor of chemotherapy-induced myelosuppression in gastric cancer patients, with a threshold of ≤48 identifying high-risk individuals. This readily available biomarker may guide personalized preventive strategies, particularly for male patients.
Keywords: Prognostic nutritional index, gastric cancer, chemotherapy, myelosuppression, predictive biomarker, Nutritional Status
Received: 03 Apr 2025; Accepted: 16 Sep 2025.
Copyright: © 2025 Chen, Xiao, Xiao, Zeng, Liu, Guo and Zhang. 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: Xue-qing Zhang, 382731326@qq.com
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