The prognostic value of the geriatric nutritional risk index (GNRI) is not clear in patients with diffuse large B-cell lymphoma (DLBCL). This study was designed to analyze the GNRI in DLBCL patients and to investigate its prognostic value in DLBCL. The archive records of DLBCL patients between 2008 and 2020 at the Akdeniz University Hospital were retrospectively analyzed. A total of 206 patients with DLBCL were recruited and classified into two GNRI-based groups based on nutrition status. The GNRI cut off value was determined by ROC analysis. In the univariate Cox regression analysis for overall survival (OS), age, lactate dehydrogenase, B symptoms, infiltration of bone marrow, and the GNRI were determined as prognostic factors for mortality. The OS of patients with a GNRI ≤104.238 was significantly lower than that of patients with a GNRI >104.238 (p = 0.001). The progression-free survival (PFS) of patients with GNRI ≤104.238 was significantly lower compared to the patients with GNRI >104.238 (p = 0.010). Based on the results of the present study with a relatively large hospital-based cohort, the GNRI can be recommended for use as an independent prognostic marker for OS and PFS in patients with DLBCL.

Werner’s syndrome is a relatively rare autosomal recessive disorder characterized by several features generally associated with aging. This syndrome is classified in the group of chromosome instability syndromes and there is an increased incidence of neoplasia. Hematologic malignancies associated with this syndrome are, however, unusual. Herein we report a case of Werner’s syndrome with myelodysplastic syndrome, a clonal preleukemic disorder of hemopoietic stem cells. Such an association, to the best of our knowledge, has not been reported in the English literature so far.

Background: Adult acute lymphoblastic leukemia (ALL) patients are at increased risk of invasive fungal infections (IFIs) due to intensive therapy and prolonged neutropenia. While pediatric guidelines support administering fluconazole or mold-active agents, the evidence in adults is limited. This study presents the first multicenter retrospective comparison of fluconazole and micafungin use in this setting. Methods: We retrospectively analyzed 336 adult ALL patients from 11 centers in Türkiye (2010–2024) who received fluconazole (n = 230) or micafungin (n = 106) during induction chemotherapy. IFIs were classified according to the EORTC/MSG criteria. Results: The median age was 38.5 years, and 38.7% were female. Proven/probable IFIs occurred in 8.9% of patients, with similar rates between the fluconazole and micafungin groups (8.7% vs. 9.4%; p = 0.82). Multivariate analysis confirmed no significant association between the prophylactic antifungal type and IFI incidence, indicating comparable outcomes across groups. The median prophylaxis duration was longer with fluconazole, while the discontinuation rates, switch patterns, and subsequent antifungal use were comparable. The overall infection rates (~60%) and distribution of bacterial, viral, and polymicrobial infections were similar between the two groups. Prior bacterial infection increased the risk of IFI by 2.7-fold, and IFI-positive patients had longer neutropenia. At the end of induction, the remission, refractory, and mortality rates were similar between groups. The median overall survival was 24 months. Conclusions: Fluconazole and micafungin showed similar efficacy as the primary antifungal prophylaxis treatment in adult ALL patients. Given the limited evidence in adults and the ongoing need to optimize antifungal strategies, prospective randomized trials directly comparing these agents in this population are needed to confirm and expand upon our findings.