Abstract
BACKGROUND: Diffuse large B-cell lymphoma (DLBCL) is the most common aggressive non-Hodgkin lymphoma (NHL), accounting for 30-40% of NHL cases. It exhibits high heterogeneity in gene expression and genetics, leading to significant variability in clinical treatment outcomes. Currently, various methods are available for predicting the prognosis of DLBCL patients, including the classic International Prognostic Index (IPI), as well as gene sequencing and circulating tumor DNA (ctDNA). However, some of these prognostic stratification methods are invasive and costly, limiting their widespread application. Therefore, there is an urgent need to identify potential prognostic indicators for lymphoma that can be widely used in the prognostic assessment of DLBCL patients, thereby further improving the stratification of DLBCL prognosis. OBJECTIVE: This study aims to determine the prognostic value of serum interleukin-2 receptor (IL-2R) and prognostic nutritional index (PNI) in patients diagnosed with diffuse large B-cell lymphoma (DLBCL), as well as their applicability across different DLBCL subtypes. METHODS: A retrospective analysis was conducted on 171 newly diagnosed DLBCL patients who received standard chemotherapy at Tongji Hospital in Shanghai from March 2013 to March 2024. Among them, 136 patients completed serum IL-2R testing. Spearman's correlation analysis was used to describe the associations between different categorical indicators. The optimal cutoff values were determined based on receiver operating characteristic (ROC) curves. Kaplan-Meier analysis and log-rank tests were employed to compare survival rates among different subgroups. Finally, univariate and multivariate Cox proportional hazards regression models were applied to identify factors influencing the prognosis of DLBCL patients. RESULTS: The baseline levels of IL-2R were correlated with patient age, nutritional status, and inflammatory response. PNI was associated with tumor burden in patients. Among the 136 patients, the cutoff value for IL-2R was 1,202 U/mL, while the cutoff value for PNI in the 171 patients was 44.65. Patients with high IL-2R and low PNI shared common characteristics, including advanced age, higher Ann Arbor stage, more frequent B symptoms, higher IPI scores, a higher proportion of intermediate-to-high-risk patients, poorer performance status, and shorter overall survival (OS) and progression-free survival (PFS). Multivariate analysis indicated that IL-2R > 1,202 U/mL and PNI ≤ 44.65 were independent risk factors for poor PFS and OS in newly diagnosed DLBCL patients.