Novel Scoring System Using Geriatric Nutritional Risk Index, C-Reactive Protein, and Disease Status Predicts Survival...

Second allogeneic stem cell transplantation (SCT2) is a potentially curative treatment for relapsed hematological malignancies; however, its outcomes generally remain poor. In this multicenter retrospective study, we aimed to validate the Geriatric Nutritional Risk Index (GNRI) as a prognostic factor for SCT2 and develop a novel scoring system for predicting SCT2 outcomes. We retrospectively analyzed data from 376 patients who underwent SCT2 between 2004 and 2020. Multivariate analysis identified GNRI, disease status, and C-reactive protein (CRP) levels as independent prognostic factors for overall survival (OS). Patients with a high GNRI (≥92.0) had significantly better 3-year OS (36.0% versus 14.3%, P < .001) and lower non-relapse mortality (27.2% versus 50.9%, P < .001) than those with a low GNRI. A novel scoring system incorporating GNRI, disease status, and CRP levels effectively stratified patients into low-, intermediate-, and high-risk groups, with respective 3-year OS rates of 50.7%, 29.5%, and 11.1%. Our findings highlight the importance of nutritional status in SCT2 outcomes and provide a practical tool for risk classification. The inclusion of patient- and disease-specific factors in this scoring system offers new insights into optimizing treatment strategies and improving outcomes following SCT2. Further studies are needed to evaluate interventions based on this approach.