Clinical impacts of inflammatory markers and clinical factors in patients with relapsed or refractory diffuse large B-cell lymphoma.

Background: Systemic inflammatory response can be associated with the prognosis of diffuse large B cell lymphoma (DLBCL). We investigated the systemic factors significantly related to clinical outcome in relapsed/refractory DLBCL.

Methods: In 242 patients with DLBCL, several factors, including inflammatory markers were analyzed. We assessed for the correlation between the survivals [progression-free survival (PFS) and overall survival (OS)] and prognostic factors.

Results: In these patients, a high derived neutrophil/lymphocyte ratio (dNLR) (PFS, HR=2.452, =0.002; OS, HR=2.542, =0.005), high Glasgow Prognostic Score (GPS) (PFS, HR=2.435, =0.002; OS, HR=2.621, =0.002), and high NCCN-IPI (PFS, HR=2.836, =0.003; OS, HR=2.928, =0.003) were significantly associated with survival in multivariate analysis. Moreover, we proposed a risk stratification model based on dNLR, GPS, and NCCN-IPI, thereby distributing patients into 4 risk groups. There were significant differences in survival among the 4 risk groups (PFS, <0.001; OS, <0.001).

Conclusion: In conclusion, dNLR, GPS, and NCCN-IPI appear to be excellent prognostic parameters for survival in relapsed/refractory DLBCL.