JCHOR

The Journal of Current Hematology & Oncology Research regularly publishes internationally qualified research in hematology and oncology within the current scholarly knowledge.

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Original Article
Prognostic factors in diffuse large B cell lymphoma: a retrospective analysis from a tertiary center
Aims: This study aimed to evaluate the clinical characteristics and mortality risk factors of patients diagnosed with diffuse large B-cell lymphoma (DLBCL) in our center.
Methods: This cross-sectional study retrospectively analyzed the medical records of 74 DLBCL patients followed at the Hematology Clinic of Van Yüzüncü Yıl University between September 2016 and September 2021. Demographic characteristics, clinical findings, stage, treatments, and mortality-related risk factors were evaluated. Univariate and multivariable logistic regression analyses were performed to identify independent predictors of mortality.
Results: The median age of the patients was 54 years, and 59.5% were male. Of the patients, 29.7% resided in rural areas, and 66.2% were employed. The most common initial presentation was lymphadenopathy (56.8%), followed by B symptoms (43.2%). Regarding disease stage, 32.4% had stage III, 31.1% had stage IV, and 18.9% had bone marrow involvement. The mean International Prognostic Index (IPI) score was 2.07 ± 1.67. R-CHOP was administered to 85.1% of patients, while 14.9% received R-EPOCH, and 5.4% were referred to other centers. Among the 25 deceased patients (33.8%), compared to the 49 survivors (66.2%), rural residency, unemployment, older age, presentation with B symptoms, stage IV disease, bone marrow involvement, triple-hit lymphoma, and higher IPI scores were significantly more common (p<0.05). In multivariable logistic regression analysis, rural residency (OR: 93.706, 95% CI: 1.789–4908.115, p=0.025) and higher IPI scores (OR: 18.595, 95% CI: 2.761–125.236, p=0.003) were identified as independent risk factors for mortality in DLBCL patients.
Conclusion: This study demonstrated that rural residency and higher IPI scores are independent risk factors for mortality in DLBCL patients. Future multicenter prospective cohort studies with larger sample sizes and broader clinical parameters are needed to better define the risk factors associated with mortality in DLBCL.


1. Sehn LH, Salles G. Diffuse large B-cell lymphoma. N Engl J Med. 2021; 384(9):842-858. doi:10.1056/NEJMra2027612
2. Cheson BD, Fisher RI, Barrington SF, et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol. 2014; 32(27):3059-3068. doi:10.1200/JCO.2013.54.8800
3. Barrington SF, Mikhaeel NG, Kostakoglu L, et al. Role of imaging in the staging and response assessment of lymphoma: consensus of the International Conference on Malignant Lymphomas Imaging Working Group. J Clin Oncol. 2014;32(27):3048-3058. doi:10.1200/JCO.2013.53. 5229
4. Cheson BD, Ansell S, Schwartz L, et al. Refinement of the Lugano Classification lymphoma response criteria in the era of immunomodulatory therapy. Blood. 2016;128(21):2489-2496. doi:10. 1182/blood-2016-05-718528
5. Sehn LH, Berry B, Chhanabhai M, et al. The revised International Prognostic Index (R-IPI) is a better predictor of outcome than the standard IPI for patients with diffuse large B-cell lymphoma treated with R-CHOP. Blood. 2007;109(5):1857-1861. doi:10.1182/blood-2006- 08-038257
6. Prognostic IN-HsL. Factors project. A predictive model for aggressive non-Hodgkin&rsquo;s lymphoma: the International Non-Hodgkin&rsquo;s Lymphoma Prognostic Factor Project. N Eng J Med. 1993;329:987-994.
7. Ruppert AS, Dixon JG, Salles G, et al. International prognostic indices in diffuse large B-cell lymphoma: a comparison of IPI, R-IPI, and NCCN-IPI. Blood. 2020;135(23):2041-2048. doi:10.1182/blood.2019002729
8. Zhou Z, Sehn LH, Rademaker AW, et al. An enhanced International Prognostic Index (NCCN-IPI) for patients with diffuse large B-cell lymphoma treated in the rituximab era. Blood. 2014;123(6):837-842. doi:10.1182/blood-2013-09-524108
9. Campo E, Harris N, Pileri S. WHO Classification of tumours of haematopoietic and lymphoid tissues. Lyon, France: International Agency for Research on. Cancer. 2017.
10. Wight JC, Chong G, Grigg AP, Hawkes EA. Prognostication of diffuse large B-cell lymphoma in the molecular era: moving beyond the IPI. Blood Rev. 2018;32(5):400-415. doi:10.1016/j.blre.2018.03.005
11. Crump M, Neelapu SS, Farooq U, et al. Outcomes in refractory diffuse large B-cell lymphoma: results from the international SCHOLAR-1 study. Blood. 2017;130(16):1800-1808. doi:10.1182/blood-2017-03- 769620
12. Yin X, Xu A, Fan F, et al. Incidence and mortality trends and risk prediction nomogram for extranodal diffuse large B-cell lymphoma: an analysis of the surveillance, epidemiology, and end results database. Front Oncol. 2019;9:1198. doi:10.3389/fonc.2019.01198
13. Yang QP, Zhang WY, Yu JB, et al. Subtype distribution of lymphomas in Southwest China: analysis of 6,382 cases using WHO classification in a single institution. Diagn Pathol. 2011;6(1):77. doi:10.1186/1746-1596-6-77
14. Kanumuri VV, Khan MN, Vazquez A, Govindaraj S, Baredes S, Eloy JA. Diffuse large B-cell lymphoma of the sinonasal tract: analysis of survival in 852 cases. Am J Otolaryngol. 2014;35(2):154-158. doi:10.1016/ j.amjoto.2013.09.003
15. Hedstr&ouml;m G, Hagberg O, Jerkeman M, Enblad G, Group SLS. The impact of age on survival of diffuse large B-cell lymphoma-a population-based study. Acta Oncol. 2015;54(6):916-923. doi:10.3109/ 0284186X.2014.978367
16. Garcia-Recio M, Wudhikarn K, Pennisi M, et al. The International Prognostic Index is associated with outcomes in diffuse large B cell lymphoma after CAR T cell therapy. Transplant Cell Ther. 2021;27(3): 233-240. doi:10.1016/j.jtct.2020.10.022
17. Kim K, Jorge VM, Tiu A, et al. Early mortality after diagnosis of diffuse large B-cell lymphoma: a retrospective, single urban-community hospital study. Blood. 2019;134:5335. doi:10.1182/blood-2019-132126
18. Tao L, Foran JM, Clarke CA, Gomez SL, Keegan TH. Socioeconomic disparities in mortality after diffuse large B-cell lymphoma in the modern treatment era. Blood. 2014;123(23):3553-3562. doi:10.1182/blood-2013-07-517110
19. Loberiza Jr FR, Cannon AJ, Weisenburger DD, et al. Survival disparities in patients with lymphoma according to place of residence and treatment provider: a population-based study. J Clin Oncol. 2009;27(32): 5376-5382. doi:10.1200/JCO.2009.22.0038
20. Lee B, Goktepe O, Hay K, et al. Effect of place of residence and treatment on survival outcomes in patients with diffuse large B-cell lymphoma in British Columbia. Oncologist. 2014;19(3):283-290. doi:10.1634/theoncologist.2013-0343
21. Sorice KA, Fang CY, Wiese D, et al. Systematic review of neighborhood socioeconomic indices studied across the cancer control continuum. Cancer Med. 2022;11(10):2125-2144. doi:10.1002/cam4.4601
22. Auvinen A, Karjalainen S, Pukkala E. Social class and cancer patient survival in Finland. Am J Epidemiol. 1995;142(10):1089-1102. doi:10. 1093/oxfordjournals.aje.a117562
23. Auvinen A, Karjalainen S. Possible explanations for social class differences in cancer patient survival. IARC Sci Publ. 1997;(138):377-397.
24. Bradley CJ, Given CW, Roberts C. Race, socioeconomic status, and breast cancer treatment and survival. J Natl Cancer Inst. 2002;94(7):490-496. doi:10.1093/jnci/94.7.490
Volume 3, Issue 3, 2025
Page : 62-66
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