Abstract
The prognostic impact of exposure to PM(2.5) and its components across multiple time windows in DLBCL remains unclear. A total of 1,154 newly diagnosed DLBCL patients were included across seven medical centers. Individual exposures to PM(2.5) and its five chemical components, including SO(4) (2-), NO(3) (-), NH(4) (+), OM, and BC, were estimated across four exposure windows of 1, 3, 5, and 10 years before diagnosis. OM averaged over 1 year (HR = 1.319; 95% CI: 1.035-1.681) and 5 years (HR = 1.325; 95% CI, 1.070-1.641), as well as SO(4) (2-) averaged over 3 years (HR = 1.348; 95% CI, 1.008-1.801), were associated with worse prognosis in DLBCL patients. Dose-response patterns were observed in quartile-based analyses. In multi-pollutant analysis, the combined mixture of five components averaged over 3 years was also associated with adverse prognosis. However, given the observational design, causal inference cannot be established, and further validation is warranted.