{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T21:45:44Z","timestamp":1786398344594,"version":"build-2736575974"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"\n Background<\/jats:title>\n Allogeneic hematopoietic stem cell transplantation (Allo-HSCT) is an effective treatment for Acute Myeloid Leukemia (AML). The pre-transplantation Prognostic Nutritional Index (PNI) plays a critical role in determining patient prognosis, however, its correlation with mortality within 180 days after SCT is currently unclear.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to investigate the association between PNI and mortality within 180 days among AML patients who underwent HSCT.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We conducted a cohort study by retrospectively collecting data from AML patients who underwent HSCT. The PNI was calculated and recorded as serum albumin (g\/L) + 5 \u00d7 peripheral blood lymphocyte count (10\n 9<\/jats:sup>\n \/L) using pre-transplantation laboratory data. Patients were divided into three groups based on PNI tertiles. A Cox proportional hazards model was employed to explore the nonlinear relationship between PNI and mortality in these patients. The correlation between pre-transplant PNI and hematopoietic reconstitution, as well as complications such as gastrointestinal bleeding, fever, and graft-versus-host disease (GVHD), was also analyzed.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n This retrospective cohort study included 477 adult patients with AML. The mean age of the patients was 37.4 \u00b1 11.8 years, with males accounting for 55.6%. The vast majority (79.5%) of patients received transplants from related donors. Among those patients, 13.2% died within 180 days after transplantation. Patients with PNI T1 (30.2\u201344.6) had a significantly higher adjusted hazard ratio (HR) for mortality (1.52; 95% confidence intervals (CI), 1.17\u20131.98;\n p<\/jats:italic>\n \u00a0=\u00a00.002) compared with PNI T2 (44.7\u201349.1), while PNI T3 (49.2\u2013102.6) did not show increased risk (HR, 1.05; 95% CI, 0.81\u20131.35;\n p<\/jats:italic>\n \u00a0=\u00a00.732). A PNI threshold of 46 marked a significant decrease in mortality risk with increasing PNI values, suggesting a critical point for nutritional intervention. Above this threshold, PNI showed no further prognostic value, indicating a plateau effect. These findings underscore PNI\u2019s potential in guiding targeted nutritional support to improve post-transplant outcomes.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The PNI exhibits a L-shaped association with 180-day mortality in AML patients post-HSCT, emerging as a significant predictor with a critical threshold identified at PNI 46. Below this threshold, declining PNI values correlate with increased mortality risk, underscoring its clinical utility in driving nutritional interventions to enhance post-transplant survival outcomes.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fonc.2026.1754463","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T05:34:43Z","timestamp":1770183283000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Association between the prognostic nutritional index and early mortality of AML patients after allogeneic HSCT: a retrospective cohort analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Jie","family":"Tang","sequence":"first","affiliation":[{"name":"Department of Hematology, The Second Affiliated Hospital of Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Ran","sequence":"additional","affiliation":[{"name":"Department of Hematology, The Second Affiliated Hospital of Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gangping","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Hematology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"LiQuan","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Hematology, The Second Affiliated Hospital of Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Hematology, The Second Affiliated Hospital of Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yali","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Hematology, The Second Affiliated Hospital of Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yimei","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Hematology, The Second Affiliated Hospital of Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoli","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Hematology, The Second Affiliated Hospital of Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Hematology, The Second Affiliated Hospital of Army Medical 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