Analysis of prognostic factors in primary extranodal diffuse large B-Cell lymphoma
XU Chengbo
HUANG Cailing
HONG Shisen
LI Cancan
ZHENG Ruiji
Abstract：Objective To analyze the prognostic factors of primary extranodal diffuse large B-cell lymphoma(PE-DLBCL).Methods Totally 151 patients with PE-DLBCL who received first-line systemic treatment were retrospectively selected.The clinical data,including age,gender,clinical stage,presence of systemic B symptoms,Eastern Cooperative Oncology Group(ECOG)performance status,the number of extranodal sites involved,primary site,International Prognos-tic Index(IPI)score,hemoglobin(HGB)level,serum albumin(ALB)level,lactate dehydrogenase(LDH)level,β2-mi-croglobulin(β2-MG)level,Ki-67 index,cell-of-origin subtype,double-expressor lymphoma(DEL)phenotype,treatment regimens,and clinical outcomes were collected.Patients were followed up.Based on survival status,the Kaplan-Meier method was used to plot survival curves and we calculated the 3-year overall survival(OS)rate and progression-free surviv-al(PFS)rate.Univariate analysis was performed using the Log-Rank test,and multivariate analysis was conducted using the Cox proportional hazards model.Results Among the 151 patients,97 survived,39 died,and 15 were not evaluable for disease status due to lack of systematic examination.The 3-year PFS rate was(66.9±4.6)%,and the 3-year OS rate was(74.2±4.5)%.Univariate analysis showed that factors significantly associated with the 3-year PFS rate included age>60 years,bone marrow involvement,primary site in the gastrointestinal tract,primary central nervous system(CNS)lymphoma,IPI score>2,HGB<110 g/L,elevated LDH,non-germinal center B-cell-like(non-GCB)subtype,DEL phenotype,and failure to achieve complete remission(CR)after 4 treatment cycles(all P<0.05).Factors significantly as-sociated with the 3-year OS rate included age>60 years,involvement of≥2 extranodal sites,bone marrow involvement,primary site in the gastrointestinal tract,primary CNS lymphoma,IPI score>2,HGB<110 g/L,non-GCB subtype,DEL phenotype,and failure to achieve CR after 4 treatment cycles(all P<0.05).Multivariate analysis indicated that bone mar-row involvement and primary CNS lymphoma were independent risk factors for the 3-year PFS rate(both P<0.05).Mean-while,primary CNS lymphoma,HGB<110 g/L,non-GCB subtype,and DEL phenotype were independent risk factors for the 3-year OS rate(all P<0.05).Conclusions Bone marrow involvement,primary CNS lymphoma,HGB<110 g/L,non-GCB subtype,and DEL phenotype,etc.are significant prognostic factors in patients with PE-DLBCL,and they can serve as reference indicators for prognostic evaluation.
Keywords：lymphomadiffuse large B-cell lymphomaextranodal diffuse large B-cell lymphomainfluencing factors
Publication Date：2026-01-25
Online Publishing Date：2026-03-05(First online date of this platform, not the publication date of the document)
Pages：5( 109-113 )