Daily News

The dynamic effects of nutritional status on chemotherapy-related toxicity in patients with non-Hodgkin’s lymphoma

Abstract

Background/Objectives

Understanding the dynamic changes in nutritional status of patients with non-Hodgkin’s lymphoma (NHL) during chemotherapy is crucial, as it significantly impacts chemotherapy-related toxicity and survival outcomes.

Subjects/Methods

This multi-center study included newly diagnosed NHL patients. Nutritional status and chemotherapy-related toxic effects were assessed over the first five chemotherapy sessions, with follow-ups conducted every 3 months. Patients were categorized into three groups based on pre-chemotherapy Patient-Generated Subjective Global Assessment (PG-SGA) scores: Group A (0–1), Group B (2–8), and Group C (>9). Repeated-measures ANOVA and Generalized Estimating Equations (GEE) models were used for analysis, with survival outcomes evaluated via Kaplan–Meier and Cox regression.

Results

A total of 143 patients (mean age 50.26 ± 15.02 years) completed the study, over a median follow-up of 18.8 months. PG-SGA scores were highest in Group C during chemotherapy (P < 0.001), with significant time-group interaction effects (P < 0.001). Liver and kidney impairments worsened across all groups (P < 0.05), while gastrointestinal toxicity and bone marrow suppression initially decreased before increasing. GEE analysis showed that nutritional status positively influenced gastrointestinal toxicity (β = 0.05, P = 0.001) and bone marrow suppression (β = 0.04, P = 0.014). Malnourished patients exhibited worse pulmonary infection-free survival and overall survival (P < 0.05).

Conclusions

NHL patients are highly susceptible to malnutrition during chemotherapy, which exacerbates chemotherapy-related toxicities, particularly gastrointestinal effects and myelosuppression. Maintaining good initial nutrition is vital for reducing toxicities and improving survival outcomes.

This is a preview of subscription content, access via your institution

Access options

/* style specs start */

/* style specs end */

Buy this article

  • Purchase on SpringerLink
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

/* style specs start */
style {
display: none !important;
}
.LiveAreaSection * {
align-content: stretch;
align-items: stretch;
align-self: auto;
animation-delay: 0s;
animation-direction: normal;
animation-duration: 0s;
animation-fill-mode: none;
animation-iteration-count: 1;
animation-name: none;
animation-play-state: running;
animation-timing-function: ease;
azimuth: center;
backface-visibility: visible;
background-attachment: scroll;
background-blend-mode: normal;
background-clip: borderBox;
background-color: transparent;
background-image: none;
background-origin: paddingBox;
background-position: 0 0;
background-repeat: repeat;
background-size: auto auto;
block-size: auto;
border-block-end-color: currentcolor;
border-block-end-style: none;
border-block-end-width: medium;
border-block-start-color: currentcolor;
border-block-start-style: none;
border-block-start-width: medium;
border-bottom-color: currentcolor;
border-bottom-left-radius: 0;
border-bottom-right-radius: 0;
border-bottom-style: none;
border-bottom-width: medium;
border-collapse: separate;
border-image-outset: 0s;
border-image-repeat: stretch;
border-image-slice: 100%;
border-image-source: none;
border-image-width: 1;
border-inline-end-color: currentcolor;
border-inline-end-style: none;
border-inline-end-width: medium;
border-inline-start-color: currentcolor;
border-inline-start-style: none;
border-inline-start-width: medium;
border-left-color: currentcolor;
border-left-style: none;
border-left-width: medium;
border-right-color: currentcolor;
border-right-style: none;
border-right-width: medium;
border-spacing: 0;
border-top-color: currentcolor;
border-top-left-radius: 0;
border-top-right-radius: 0;
border-top-style: none;
border-top-width: medium;
bottom: auto;
box-decoration-break: slice;
box-shadow: none;
box-sizing: border-box;
break-after: auto;
break-before: auto;
break-inside: auto;
caption-side: top;
caret-color: auto;
clear: none;
clip: auto;
clip-path: none;
color: initial;
column-count: auto;
column-fill: balance;
column-gap: normal;
column-rule-color: currentcolor;
column-rule-style: none;
column-rule-width: medium;
column-span: none;
column-width: auto;
content: normal;
counter-increment: none;
counter-reset: none;
cursor: auto;
display: inline;
empty-cells: show;
filter: none;
flex-basis: auto;
flex-direction: row;
flex-grow: 0;
flex-shrink: 1;
flex-wrap: nowrap;
float: none;
font-family: initial;
font-feature-settings: normal;
font-kerning: auto;
font-language-override: normal;
font-size: medium;
font-size-adjust: none;
font-stretch: normal;
font-style: normal;
font-synthesis: weight style;
font-variant: normal;
font-variant-alternates: normal;
font-variant-caps: normal;
font-variant-east-asian: normal;
font-variant-ligatures: normal;
font-variant-numeric: normal;
font-variant-position: normal;
font-weight: 400;
grid-auto-columns: auto;
grid-auto-flow: row;
grid-auto-rows: auto;
grid-column-end: auto;
grid-column-gap: 0;
grid-column-start: auto;
grid-row-end: auto;
grid-row-gap: 0;
grid-row-start: auto;
grid-template-areas: none;
grid-template-columns: none;
grid-template-rows: none;
height: auto;
hyphens: manual;
image-orientation: 0deg;
image-rendering: auto;
image-resolution: 1dppx;
ime-mode: auto;
inline-size: auto;
isolation: auto;
justify-content: flexStart;
left: auto;
letter-spacing: normal;
line-break: auto;
line-height: normal;
list-style-image: none;
list-style-position: outside;
list-style-type: disc;
margin-block-end: 0;
margin-block-start: 0;
margin-bottom: 0;
margin-inline-end: 0;
margin-inline-start: 0;
margin-left: 0;
margin-right: 0;
margin-top: 0;
mask-clip: borderBox;
mask-composite: add;
mask-image: none;
mask-mode: matchSource;
mask-origin: borderBox;
mask-position: 0 0;
mask-repeat: repeat;
mask-size: auto;
mask-type: luminance;
max-height: none;
max-width: none;
min-block-size: 0;
min-height: 0;
min-inline-size: 0;
min-width: 0;
mix-blend-mode: normal;
object-fit: fill;
object-position: 50% 50%;
offset-block-end: auto;
offset-block-start: auto;
offset-inline-end: auto;
offset-inline-start: auto;
opacity: 1;
order: 0;
orphans: 2;
outline-color: initial;
outline-offset: 0;
outline-style: none;
outline-width: medium;
overflow: visible;
overflow-wrap: normal;
overflow-x: visible;
overflow-y: visible;
padding-block-end: 0;
padding-block-start: 0;
padding-bottom: 0;
padding-inline-end: 0;
padding-inline-start: 0;
padding-left: 0;
padding-right: 0;
padding-top: 0;
page-break-after: auto;
page-break-before: auto;
page-break-inside: auto;
perspective: none;
perspective-origin: 50% 50%;
pointer-events: auto;
position: static;
quotes: initial;
resize: none;
right: auto;
ruby-align: spaceAround;
ruby-merge: separate;
ruby-position: over;
scroll-behavior: auto;
scroll-snap-coordinate: none;
scroll-snap-destination: 0 0;
scroll-snap-points-x: none;
scroll-snap-points-y: none;
scroll-snap-type: none;
shape-image-threshold: 0;
shape-margin: 0;
shape-outside: none;
tab-size: 8;
table-layout: auto;
text-align: initial;
text-align-last: auto;
text-combine-upright: none;
text-decoration-color: currentcolor;
text-decoration-line: none;
text-decoration-style: solid;
text-emphasis-color: currentcolor;
text-emphasis-position: over right;
text-emphasis-style: none;
text-indent: 0;
text-justify: auto;
text-orientation: mixed;
text-overflow: clip;
text-rendering: auto;
text-shadow: none;
text-transform: none;
text-underline-position: auto;
top: auto;
touch-action: auto;
transform: none;
transform-box: borderBox;
transform-origin: 50% 50%0;
transform-style: flat;
transition-delay: 0s;
transition-duration: 0s;
transition-property: all;
transition-timing-function: ease;
vertical-align: baseline;
visibility: visible;
white-space: normal;
widows: 2;
width: auto;
will-change: auto;
word-break: normal;
word-spacing: normal;
word-wrap: normal;
writing-mode: horizontalTb;
z-index: auto;
-webkit-appearance: none;
-moz-appearance: none;
-ms-appearance: none;
appearance: none;
margin: 0;
}
.LiveAreaSection {
width: 100%;
}
.LiveAreaSection .login-option-buybox {
display: block;
width: 100%;
font-size: 17px;
line-height: 30px;
color: #222;
padding-top: 30px;
font-family: Harding, Palatino, serif;
}
.LiveAreaSection .additional-access-options {
display: block;
font-weight: 700;
font-size: 17px;
line-height: 30px;
color: #222;
font-family: Harding, Palatino, serif;
}
.LiveAreaSection .additional-login > li:not(:first-child)::before {
transform: translateY(-50%);
content: “”;
height: 1rem;
position: absolute;
top: 50%;
left: 0;
border-left: 2px solid #999;
}
.LiveAreaSection .additional-login > li:not(:first-child) {
padding-left: 10px;
}
.LiveAreaSection .additional-login > li {
display: inline-block;
position: relative;
vertical-align: middle;
padding-right: 10px;
}
.BuyBoxSection {
display: flex;
flex-wrap: wrap;
flex: 1;
flex-direction: row-reverse;
margin: -30px -15px 0;
}
.BuyBoxSection .box-inner {
width: 100%;
height: 100%;
padding: 30px 5px;
display: flex;
flex-direction: column;
justify-content: space-between;
}
.BuyBoxSection p {
margin: 0;
}
.BuyBoxSection .readcube-buybox {
background-color: #f3f3f3;
flex-shrink: 1;
flex-grow: 1;
flex-basis: 255px;
background-clip: content-box;
padding: 0 15px;
margin-top: 30px;
}
.BuyBoxSection .subscribe-buybox {
background-color: #f3f3f3;
flex-shrink: 1;
flex-grow: 4;
flex-basis: 300px;
background-clip: content-box;
padding: 0 15px;
margin-top: 30px;
}
.BuyBoxSection .subscribe-buybox-nature-plus {
background-color: #f3f3f3;
flex-shrink: 1;
flex-grow: 4;
flex-basis: 100%;
background-clip: content-box;
padding: 0 15px;
margin-top: 30px;
}
.BuyBoxSection .title-readcube,
.BuyBoxSection .title-buybox {
display: block;
margin: 0;
margin-right: 10%;
margin-left: 10%;
font-size: 24px;
line-height: 32px;
color: #222;
text-align: center;
font-family: Harding, Palatino, serif;
}
.BuyBoxSection .title-asia-buybox {
display: block;
margin: 0;
margin-right: 5%;
margin-left: 5%;
font-size: 24px;
line-height: 32px;
color: #222;
text-align: center;
font-family: Harding, Palatino, serif;
}
.BuyBoxSection .asia-link,
.Link-328123652,
.Link-2926870917,
.Link-2291679238,
.Link-595459207 {
color: #069;
cursor: pointer;
text-decoration: none;
font-size: 1.05em;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
line-height: 1.05em6;
}
.BuyBoxSection .access-readcube {
display: block;
margin: 0;
margin-right: 10%;
margin-left: 10%;
font-size: 14px;
color: #222;
padding-top: 10px;
text-align: center;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
line-height: 20px;
}
.BuyBoxSection ul {
margin: 0;
}
.BuyBoxSection .link-usp {
display: list-item;
margin: 0;
margin-left: 20px;
padding-top: 6px;
list-style-position: inside;
}
.BuyBoxSection .link-usp span {
font-size: 14px;
color: #222;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
line-height: 20px;
}
.BuyBoxSection .access-asia-buybox {
display: block;
margin: 0;
margin-right: 5%;
margin-left: 5%;
font-size: 14px;
color: #222;
padding-top: 10px;
text-align: center;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
line-height: 20px;
}
.BuyBoxSection .access-buybox {
display: block;
margin: 0;
margin-right: 10%;
margin-left: 10%;
font-size: 14px;
color: #222;
opacity: 0.8px;
padding-top: 10px;
text-align: center;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
line-height: 20px;
}
.BuyBoxSection .price-buybox {
display: block;
font-size: 30px;
color: #222;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
padding-top: 30px;
text-align: center;
}
.BuyBoxSection .price-buybox-to {
display: block;
font-size: 30px;
color: #222;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
text-align: center;
}
.BuyBoxSection .price-info-text {
font-size: 16px;
padding-right: 10px;
color: #222;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
}
.BuyBoxSection .price-value {
font-size: 30px;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
}
.BuyBoxSection .price-per-period {
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
}
.BuyBoxSection .price-from {
font-size: 14px;
padding-right: 10px;
color: #222;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
line-height: 20px;
}
.BuyBoxSection .issue-buybox {
display: block;
font-size: 13px;
text-align: center;
color: #222;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
line-height: 19px;
}
.BuyBoxSection .no-price-buybox {
display: block;
font-size: 13px;
line-height: 18px;
text-align: center;
padding-right: 10%;
padding-left: 10%;
padding-bottom: 20px;
padding-top: 30px;
color: #222;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
}
.BuyBoxSection .vat-buybox {
display: block;
margin-top: 5px;
margin-right: 20%;
margin-left: 20%;
font-size: 11px;
color: #222;
padding-top: 10px;
padding-bottom: 15px;
text-align: center;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
line-height: 17px;
}
.BuyBoxSection .tax-buybox {
display: block;
width: 100%;
color: #222;
padding: 20px 16px;
text-align: center;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
line-height: NaNpx;
}
.BuyBoxSection .button-container {
display: flex;
padding-right: 20px;
padding-left: 20px;
justify-content: center;
}
.BuyBoxSection .button-container > * {
flex: 1px;
}
.BuyBoxSection .button-container > a:hover,
.Button-505204839:hover,
.Button-1078489254:hover,
.Button-2737859108:hover {
text-decoration: none;
}
.BuyBoxSection .btn-secondary {
background: #fff;
}
.BuyBoxSection .button-asia {
background: #069;
border: 1px solid #069;
border-radius: 0;
cursor: pointer;
display: block;
padding: 9px;
outline: 0;
text-align: center;
text-decoration: none;
min-width: 80px;
margin-top: 75px;
}
.BuyBoxSection .button-label-asia,
.ButtonLabel-3869432492,
.ButtonLabel-3296148077,
.ButtonLabel-1636778223 {
display: block;
color: #fff;
font-size: 17px;
line-height: 20px;
font-family: -apple-system, BlinkMacSystemFont, “Segoe UI”, Roboto,
Oxygen-Sans, Ubuntu, Cantarell, “Helvetica Neue”, sans-serif;
text-align: center;
text-decoration: none;
cursor: pointer;
}
.Button-505204839,
.Button-1078489254,
.Button-2737859108 {
background: #069;
border: 1px solid #069;
border-radius: 0;
cursor: pointer;
display: block;
padding: 9px;
outline: 0;
text-align: center;
text-decoration: none;
min-width: 80px;
max-width: 320px;
margin-top: 20px;
}
.Button-505204839 .btn-secondary-label,
.Button-1078489254 .btn-secondary-label,
.Button-2737859108 .btn-secondary-label {
color: #069;
}
.uList-2102244549 {
list-style: none;
padding: 0;
margin: 0;
}
/* style specs end */

Fig. 1: Participants and study flowchart.
Fig. 2: Changes of toxic effects in three groups during chemotherapy.
Fig. 3: Effect of initial nutrition status on the pulmonary infection-free survival (N = 157).
Fig. 4: Effect of initial nutrition status on OS in NHL patients (N = 157).

Data availability

The authors declare that all the other data supporting the findings of this study are available within the article, its Supplementary Information files, or from the corresponding author upon reasonable request.

References

  1. Wang L, Jin YP, Gao G, Wu DY, Zhou XJ, Liu YY. et al. Clinicopathological features and molecular genetics of Burkitt-like lymphoma with 11q aberration. Zhonghua Bing Li Xue Za Zhi. 2021;50:655–7.

    CAS 
    PubMed 

    Google Scholar 

  2. Allemani C, Matsuda T, Di Carlo V, Harewood R, Matz M, Nikšić M. et al. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet. 2018;391:1023–75.

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  3. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68:394–424.

    Article 
    PubMed 

    Google Scholar 

  4. Melekoglu R, Ciftci O, Eraslan S, Cetin A, Basak N. Beneficial effects of curcumin and capsaicin on cyclophosphamide-induced premature ovarian failure in a rat model. J Ovarian Res. 2018;11:33.

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  5. Abdel-Aziz AM, Mohamed ASM, Abdelazem O, Okasha AMM, Kamel MY. Cilostazol protects against cyclophosphamide-induced ovarian toxicity in female rats: role of cAMP and HO-1. Toxicol Mech Methods. 2020;30:526–35.

    Article 
    CAS 
    PubMed 

    Google Scholar 

  6. Chuang TM, Liu YC, Hsiao HH, Wang HC, Du JS, Yeh TJ. et al. Low geriatric nutritional risk index is associated with poorer prognosis in elderly diffuse large B-cell lymphoma patients unfit for intensive anthracycline-containing therapy: a real-world study. Nutrients. 2021;13:3243.

    Article 
    CAS 
    PubMed 
    PubMed Central 

    Google Scholar 

  7. Ryan AM, Prado CM, Sullivan ES, Power DG, Daly LE. Effects of weight loss and sarcopenia on response to chemotherapy, quality of life, and survival. Nutrition. 2019;67–68:110539.

    Article 
    PubMed 

    Google Scholar 

  8. Gurdogan M, Ozkan U. A novel predictor of chemotherapeutic cardiotoxicity in patients with non-Hodgkin lymphoma. Oncol Res Treat. 2019;42:375–81.

    Article 
    CAS 
    PubMed 

    Google Scholar 

  9. Hu C, Li Q, Shou J, Zhang FX, Li X, Wu M, et al. Constructing a predictive model of depression in chemotherapy patients with non-Hodgkin’s lymphoma to improve medical staffs’ psychiatric care. Biomed Res Int. 2021;2021:9201235.

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  10. Barret M, Malka D, Aparicio T, Dalban C, Locher C, Sabate JM, et al. Nutritional status affects treatment tolerability and survival in metastatic colorectal cancer patients: results of an AGEO prospective multicenter study. Oncology. 2011;81:395–402.

    Article 
    CAS 
    PubMed 

    Google Scholar 

  11. Horwitz S, O’Connor OA, Pro B, Illidge T, Fanale M, Advani R. et al. Brentuximab vedotin with chemotherapy for CD30-positive peripheral T-cell lymphoma (ECHELON-2): a global, double-blind, randomised, phase 3 trial. Lancet. 2019;393:229–40.

    Article 
    CAS 
    PubMed 

    Google Scholar 

  12. Tay T, Somasundaram N, Lim C, Khoo LP, Goh AZK, Lee YS. et al. Treatment outcomes of T and natural-killer/T-cell lymphoma with ifosfamide, carboplatin and etoposide chemotherapy. Cancer Rep. 2022;5:e1552.

    Article 
    CAS 

    Google Scholar 

  13. Le Y, Zhu H, Ye C, Lin J, Wang N, Yang T. CT radiomics analysis discriminates pulmonary lesions in patients with pulmonary MALT lymphoma and non-pulmonary MALT lymphoma. Methods. 2024;224:54–62.

    Article 
    CAS 
    PubMed 

    Google Scholar 

  14. Horino T, Inotani S, Ohnishi H, Komori M, Terada Y. Pulmonary Nocardia concava infection in a patient with mantle cell lymphoma receiving bortezomib and rituximab. Lancet Infect Dis. 2022;22:1511.

    Article 
    PubMed 

    Google Scholar 

  15. De Groot LM, Lee G, Ackerie A, van der Meij BS. Malnutrition screening and assessment in the cancer care ambulatory setting: mortality predictability and validity of the patient-generated subjective global assessment short form (PG-SGA SF) and the GLIM criteria. Nutrients. 2020;12:2287.

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  16. Zhang Z, Wan Z, Zhu Y, Zhang L, Zhang L, Wan H. Prevalence of malnutrition comparing NRS2002, MUST, and PG-SGA with the GLIM criteria in adults with cancer: a multi-center study. Nutrition. 2021;83:111072.

    Article 
    PubMed 

    Google Scholar 

  17. Frisancho AR. New norms of upper limb fat and muscle areas for assessment of nutritional status. Am J Clin Nutr. 1981;34:2540–5.

    Article 
    CAS 
    PubMed 

    Google Scholar 

  18. Yin L, Fan Y, Lin X, Zhang L, Li N, Liu J. et al. Fat mass assessment using the triceps skinfold thickness enhances the prognostic value of the Global Leadership Initiative on Malnutrition criteria in patients with lung cancer. Br J Nutr. 2022;127:1506–16.

    Article 
    CAS 
    PubMed 

    Google Scholar 

  19. Chen AP, Setser A, Anadkat MJ, Cotliar J, Olsen EA, Garden BC, et al. Grading dermatologic adverse events of cancer treatments: the Common Terminology Criteria for Adverse Events Version 4.0. J Am Acad Dermatol. 2012;67:1025–1039.

    Article 
    PubMed 

    Google Scholar 

  20. Hua Q, Zhu Y, Liu H. Severe and fatal adverse events risk associated with rituximab addition to B-cell non-Hodgkin’s lymphoma (B-NHL) chemotherapy: a meta-analysis. J Chemother. 2015;27:365–70.

    Article 
    CAS 
    PubMed 

    Google Scholar 

  21. Fox P, Darley A, Furlong E, Miaskowski C, Patiraki E, Armes J. et al. The assessment and management of chemotherapy-related toxicities in patients with breast cancer, colorectal cancer, and Hodgkin’s and non-Hodgkin’s lymphomas: a scoping review. Eur J Oncol Nurs. 2017;26:63–82.

    Article 
    PubMed 

    Google Scholar 

  22. Jung SH, Ahn C. Sample size estimation for GEE method for comparing slopes in repeated measurements data. Stat Med. 2003;22:1305–15.

    Article 
    PubMed 

    Google Scholar 

  23. Yilmaz M, Atilla FD, Sahin F, Saydam G. The effect of malnutrition on mortality in hospitalized patients with hematologic malignancy. Support Care Cancer. 2020;28:1441–8.

    Article 
    PubMed 

    Google Scholar 

  24. Go SI, Park S, Kang MH, Kim HG, Kim HR, Lee GW. Clinical impact of prognostic nutritional index in diffuse large B cell lymphoma. Ann Hematol. 2019;98:401–11.

    Article 
    CAS 
    PubMed 

    Google Scholar 

  25. Pehlivan Z, Nural N. Prevalence of constipation in patients undergoing chemotherapy and the effect of constipation on quality of life. Support Care Cancer. 2022;30:8019–28.

    Article 
    PubMed 

    Google Scholar 

  26. Zheng Z, Zhao X, Zhao Q, Zhang Y, Liu S, Liu Z, et al. The effects of early nutritional intervention on oral mucositis and nutritional status of patients with head and neck cancer treated with radiotherapy. Front Oncol. 2020;10:595632.

    Article 
    PubMed 

    Google Scholar 

  27. Toyota K, Mori M, Hirahara S, Yoshioka S, Kubota H, Yano R. et al. Nutritional status indicators affecting the tolerability of postoperative chemotherapy after total gastrectomy in patients with gastric cancer. J Gastric Cancer. 2022;22:56–66.

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  28. Santos IM, Mendes L, Carolino E, Santos CA. Nutritional status, functional status, and quality of life—what is the impact and relationship on cancer patients? Nutr Cancer. 2021;73:2554–67.

    Article 
    CAS 
    PubMed 

    Google Scholar 

  29. Guo ZQ, Yu JM, Li W, Fu ZM, Lin Y, Shi YY. et al. Survey and analysis of the nutritional status in hospitalized patients with malignant gastric tumors and its influence on the quality of life. Support Care Cancer. 2020;28:373–80.

    Article 
    PubMed 

    Google Scholar 

  30. Molassiotis A, Yam BMC, Yung H, Chan FYS, Mok TSK. Pretreatment factors predicting the development of postchemotherapy nausea and vomiting in Chinese breast cancer patients. Support Care Cancer. 2002;10:139–45.

    Article 
    CAS 
    PubMed 

    Google Scholar 

  31. Brudno JN, Kochenderfer JN. Recent advances in CAR T-cell toxicity: mechanisms, manifestations and management. Blood Rev. 2019;34:45–55.

    Article 
    CAS 
    PubMed 

    Google Scholar 

  32. Park S, Han B, Cho JW, Woo SY, Kim S, Kim SJ, et al. Effect of nutritional status on survival outcome of diffuse large B-cell lymphoma patients treated with rituximab-CHOP. Nutr Cancer. 2014;66:225–33.

    Article 
    CAS 
    PubMed 

    Google Scholar 

  33. Calistri L, Rastrelli V, Nardi C, Maraghelli D, Vidali S, Pietragalla M. et al. Imaging of the chemotherapy-induced hepatic damage: yellow liver, blue liver, and pseudocirrhosis. World J Gastroenterol. 2021;27:7866–93.

    Article 
    CAS 
    PubMed 
    PubMed Central 

    Google Scholar 

  34. Han X, Stevens J, Bradshaw PT. Body mass index, weight change, and survival in non-Hodgkin lymphoma patients in Connecticut women. Nutr Cancer. 2013;65:43–50.

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

  35. Zou Y, Xu H, Lyu Q, Weng M, Cui J, Shi H, et al. Malnutrition diagnosed by GLIM criteria better predicts long-term outcomes for patients with non-Hodgkin’s lymphoma: A prospective multicenter cohort study. Hematol Oncol. 2023;41:371–379.

    Article 
    CAS 
    PubMed 

    Google Scholar 

  36. Stauder R, Augschoell J, Hamaker ME, Koinig KA. Malnutrition in older patients with hematological malignancies at initial diagnosis—association with impairments in health status, systemic inflammation and adverse outcome. Hemasphere. 2020;4:e332.

    Article 
    PubMed 
    PubMed Central 

    Google Scholar 

Download references

Acknowledgements

This study was supported by the Natural Science Basic Research Program of Shaanxi [Program No. 2020JQ-460]. We also thank all the patients’ contribution to the study.

Author information

Author notes

  1. These authors contributed equally: Qian Zhou, HeXiang Yang.

Authors and Affiliations

  1. Department of Nutrition and Food Safety, School of Public Health, Xi’an Jiaotong University, Xi’an, China

    Qian Zhou, HeXiang Yang, Xinyue Wang, GuoHua Li, JingLin Li, JiaHui Zhang & Xiaoqin Luo

  2. Department of Hematology, Tangdu Hospital of Air Force Military Medical University, Xi’an, China

    Qian Zhou, LiHong Wang & XueQian Yan

  3. Department of Hematology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China

    BeiRong Zhang

  4. Department of Hematology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China

    XueHong Ma

  5. Department of Gastroenterology, Tangdu Hospital of Air Force Military Medical University, Xi’an, China

    ZhiHong Yan

  6. Thoracic Surgery Department, Shaanxi Provincial Cancer Hospital Affiliated to Medical College of Xi’an Jiaotong University, Xi’an, China

    Ni Bao & Jia Liu

  7. Department of Epidemiology and Health Statistics, School of Public Health, Xi’an Jiaotong University, Xi’an, China

    Chao Li

  8. Department of Cardiothoracic Surgery, The Second Affiliated Hospital of Xi’an Medical University, Xi’an, China

    Peng Ge

  9. Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi’an, China

    Xiaoqin Luo

Authors

  1. Qian Zhou
    View author publications

    You can also search for this author in
    PubMed Google Scholar

  2. HeXiang Yang
    View author publications

    You can also search for this author in
    PubMed Google Scholar

  3. Xinyue Wang
    View author publications

    You can also search for this author in
    PubMed Google Scholar

  4. LiHong Wang
    View author publications

    You can also search for this author in
    PubMed Google Scholar

  5. XueQian Yan
    View author publications

    You can also search for this author in
    PubMed Google Scholar

  6. BeiRong Zhang
    View author publications

    You can also search for this author in
    PubMed Google Scholar

  7. XueHong Ma
    View author publications

    You can also search for this author in
    PubMed Google Scholar

  8. GuoHua Li
    View author publications

    You can also search for this author in
    PubMed Google Scholar

  9. JingLin Li
    View author publications

    You can also search for this author in
    PubMed Google Scholar

  10. JiaHui Zhang
    View author publications

    You can also search for this author in
    PubMed Google Scholar

  11. ZhiHong Yan
    View author publications

    You can also search for this author in
    PubMed Google Scholar

  12. Ni Bao
    View author publications

    You can also search for this author in
    PubMed Google Scholar

  13. Chao Li
    View author publications

    You can also search for this author in
    PubMed Google Scholar

  14. Peng Ge
    View author publications

    You can also search for this author in
    PubMed Google Scholar

  15. Jia Liu
    View author publications

    You can also search for this author in
    PubMed Google Scholar

  16. Xiaoqin Luo
    View author publications

    You can also search for this author in
    PubMed Google Scholar

Contributions

Qian Zhou and Hexiang Yang equally wrote the manuscript, performed the statistical analysis, and responsible for the study design and implementation while they critically reviewed the manuscript. Jia Liu and XiaoQin Luo conceived and designed the analysis, generated the primary research hypothesis, provided input in terms of statistical analysis, and critically reviewed the manuscript. XiaoQin Luo and Chao Li provided input in terms of the analysis. Xinyue Wang, LiHong Wang, XueQian Yan, BeiRong Zhang, XueHong Ma, Guohua Li, JiaHui Zhang, XinTian Liu, JingLin Li, Ni Bao, Zhihong Yan, and Peng Ge were responsible for collecting data, provided advice on the analysis, and critically reviewed the manuscript.

Corresponding authors

Correspondence to
Jia Liu or Xiaoqin Luo.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

This study was conducted with the approval of the Ethics Committee of Xi’an Jiaotong University (No. 2021-1321) and has been registered at clinicaltrials.gov (identifier: NCT06219083). Written informed consent was obtained for all participants.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Supplementary material

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhou, Q., Yang, H., Wang, X. et al. The dynamic effects of nutritional status on chemotherapy-related toxicity in patients with non-Hodgkin’s lymphoma.
Eur J Clin Nutr (2025). https://doi.org/10.1038/s41430-025-01565-6

Download citation

  • Received: 29 May 2024

  • Revised: 10 December 2024

  • Accepted: 02 January 2025

  • Published: 14 January 2025

  • DOI: https://doi.org/10.1038/s41430-025-01565-6

news

Leave a Reply

Your email address will not be published. Required fields are marked *