Malnutrition in Older Patients With Hematological Malignancies at Initial Diagnosis – Association With Impairments in Health Status, Systemic Inflammation and Adverse Outcome
Reinhard Stauder, Julia Augschoell, Marije E. Hamaker, Karin A. Koinig
Abstract
by 29%. Lowered serum albumin (<3.5 g/dL) was prevalent in 14% of patients, and in 38% Glasgow Prognostic Score indicated hyperinflammation. Principal component analysis clustered malnutrition with inflammation markers and pronounced impairments, that is, fatigue, depression, comorbidities, reduced functional capacities. Severe decrease in food intake (HR: 3.3 (1.9-5.8), p < 0.001), >3 kg weight loss (HR: 2.3 (1.4-3.9), p = 0.001), impaired MNA (HR: 2.8 (1.3-6.2), p = 0.010), and low serum albumin (HR: 2.1 (1.1-4.0), p = 0.030) were significantly associated with shortened overall survival. Recent weight loss >3 kg (HR: 2.2 (1.1-4.3), p = 0.022), and low BMI (HR: 3.3 (1.8-6.0), p < 0.001) remained independent adverse parameters in multivariate Cox proportional hazard regression analyses. Malnourishment at initial diagnosis is frequent in older patients with hematological malignancies and represents an adverse prognosticator. Clustering of malnutrition with impairments and systemic inflammation suggests an underlying common pathway.