Abstract
INTRODUCTION: Diffuse Large B-Cell Lymphoma (DLBCL) is the most common subtype of Non-Hodgkin Lymphoma (NHL), with 20-40% of patients experiencing poor outcomes despite advancements in treatment. While Metabolic Syndrome (MetS) has been linked to NHL prognosis, its impact on DLBCL outcomes remains unclear. METHODS: This study examined the effects of dynamic changes in MetS components on DLBCL treatment outcomes and prognosis. We retrospectively analyzed 125 newly diagnosed DLBCL patients treated with 6-8 cycles of CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) or CHOP-like regimens, with or without rituximab, from May 2010 to May 2022. Group-based trajectory models were used to identify MetS component trajectories. Multivariate logistic regression and Cox proportional hazards regression were employed to determine factors affecting complete remission (CR), progression-free survival (PFS), and overall survival (OS). RESULTS: The 2-year PFS and OS rates were 70.0% and 82.0%, respectively. High baseline high-density lipoprotein cholesterol (HDL-C) was associated with reduced progression risk (HR = 0.27, 95% CI: 0.10-0.78), while high baseline low-density lipoprotein cholesterol (LDL-C) was linked to decreased CR rate (OR = 0.65, 95% CI: 0.44-0.97) and increased progression risk (HR = 1.78, 95% CI: 1.14-2.79). Additionally, high LDL-C trajectory was associated with reduced CR rates, whereas moderate BMI trajectory was associated with improved CR, PFS, and OS. DISCUSSION: Therefore, controlling LDL-C levels and maintaining a moderate BMI are crucial for improving DLBCL clinical outcomes.