Blood Res  
Clinical impacts of inflammatory markers and clinical factors in patients with relapsed or refractory diffuse large B-cell lymphoma
Do-Young Kim1#, Moo-Kon Song2#, Joo-Seop Chung1, Ho-Jin Shin1, Deok Hwan Yang3, Sung-Nam Lim4, Sung-Yong Oh5
Department of Hematology-Oncology, 1Pusan National University Hospital Medical Research Institute, Busan, 2Hanyang University Hanmaeum Changwon Hospital, Changwon, Department of Hematology, 3Chonnam National University Hwasun Hospital, Hwasun, 4Busan Haeundae Paik Hospital, 5Dong-A University Hospital, Busan, Korea
Correspondence to: Joo-Seop Chung M.D. Ph.D.
Department of Hematology-Oncology, Pusan National University Hospital Medical Research Institute, 179, Gudeok-ro, Seo-gu, Busan 49241, Korea
E-mail: hemon@pusan.ac.kr

#These authors contributed equally to this work.
Published online: November 18, 2019.
© The Korean Journal of Hematology. All rights reserved.

Abstract
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, 95% CI=1.535–3.916, P=0.002; OS, HR=2.542, 95% CI=1.208–3.664, P=0.005), high Glasgow Prognostic Score (GPS) (PFS, HR=2.435, 95% CI=1.285–3.222, P=0.002; OS, HR=2.621, 95% CI=1.131–3.815, P=0.002), and high NCCN-IPI (PFS, HR=2.836, 95% CI=1.425–5.643, P=0.003; OS, HR=2.928, 95% CI=1.415–5.649, P=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 rate among the 4 risk groups (PFS, P<0.001; OS, P<0.001).
Conclusion: In conclusion, dNLR, GPS, and NCCN-IPI are excellent prognostic parameters for survival in relapsed/refractory DLBCL.
Keywords: Derived neutrophil/lymphocyte ratio, Glasgow prognostic score, DLBCL


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