LAUSR

Introduction: The clinical course and prognosis of follicular lymphoma (FL) is diverse. Studies about prognostic nutritional index (PNI), a marker of host inflammatory and nutritional status, indicated that it is associated with prognosis in a number of cancer types but, its value in FL is unknown. Thus, we studied the prognostic significance of PNI at diagnosis for patients with FL, including those receiving radiotherapy. Methods: We reviewed FL patients inTuen Mun Hospital, Hong Kong, from 1994 to 2012 (n = 61). PNI was calculated by serum albumin (g/ L) + 5 × absolute lymphocyte count (10/L). We determined the best PNI cut‐off value using receiver operating characteristic curves. The extent to which progression‐free survival (PFS) and overall survival differed by PNI cut‐off was assessed using Kaplan–Meier and Log rank test. Cox proportional hazards model was utilized to adjust for covariates. Results: The best cut‐off for PNI was 48. Median PFS was 5.4 years. Patients who died within 3 years had a lower median PNI at baseline (Ranksum test P = 0.014). After multivariate adjustment, high PNI (≥ 48) at diagnosis is associated with superior PFS with a hazard ratio of 0.34 (95% confidence interval 0.16–0.72). Conclusions: PNI was shown to be an independent prognostic factor of PFS in FL, even after multivariate adjustment. PNI is low cost and widely available biomarker for clinicians who may use these in combination with FLIPI to better predict prognosis.