Clinical Characteristics and Prognostic Analysis of 175 Cases of Diffuse Large B-Cell Lymphoma

Objective To investigate the clinical characteristics, prognostic factors, and survival outcomes of patients with diffuse large B-cell lymphoma (DLBCL).

Methods Clinical data of 175 newly diagnosed and untreated DLBCL patients from the Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, between January 2020 and December 2023 were collected to analyze their clinical features, factors influencing prognosis, and survival.

Results Among the 175 patients, 92 (52.6%) were male. The median age was 59 years (range: 19–89), with 83 patients (47.4%) aged >60 years. B symptoms were present in 42 patients (24.0%). According to the Hans classification, 62 cases (35.4%) were of germinal center B-cell (GCB) subtype. There were 50 patients (28.6%) with an Eastern Cooperative Oncology Group (ECOG) score ≥2, 113 patients (64.6%) with Ann Arbor stage Ⅲ-Ⅳ, and 64 patients (36.6%) with an international prognostic index (IPI) score of 3–5. Elevated lactate dehydrogenase (LDH) was observed in 63 patients (36.0%), elevated β2-microglobulin (β₂-MG) in 42 patients (24.0%), and Ki-67 >80% in 53 patients (30.3%). The median follow-up time was 32.6 (16.9–43.6) months, with a 2-year overall survival (OS) rate of 85.3% and a 2-year progression-free survival (PFS) rate of 82.7%. Survival analysis showed that age >60 years, B symptoms, ECOG score ≥2, Ann Arbor stage Ⅲ-Ⅳ, IPI score >2, elevated LDH, elevated β₂-MG, Ki-67 >80%, and number of extranodal involvement ≥2 were associated with worse PFS; age >60 years, ECOG score ≥2, Ann Arbor stage Ⅲ-Ⅳ, IPI score >2, elevated LDH, elevated β₂-MG, Ki-67 >80%, and number of extranodal involvement ≥2 were associated with worse OS (all P<0.05). Multivariate analysis indicated that elevated LDH, elevated β₂-MG, and Ki-67 >80% were independent risk factors for both PFS and OS (P < 0.05).

Conclusion Elevated LDH, elevated β₂-MG and Ki-67 >80% are independent risk factors for PFS and OS in DLBCL patients, suggesting that high tumor burden and high tumor proliferation index indicate poor prognosis in DLBCL patients.