Prognostic factors in diffuse large B cell lymphoma: a retrospective analysis from a tertiary center

Aims: This study aimed to evaluate the clinical characteristics and mortality risk factors of patients diagnosed with diffuse large B-cell lymphoma (DLBCL) in our center. Methods: This cross-sectional study retrospectively analyzed the medical records of 74 DLBCL patients followed at the Hematology Clinic of Van Yüzüncü Yıl University between September 2016 and September 2021. Demographic characteristics, clinical findings, stage, treatments, and mortality-related risk factors were evaluated. Univariate and multivariable logistic regression analyses were performed to identify independent predictors of mortality. Results: The median age of the patients was 54 years, and 59.5% were male. Of the patients, 29.7% resided in rural areas, and 66.2% were employed. The most common initial presentation was lymphadenopathy (56.8%), followed by B symptoms (43.2%). Regarding disease stage, 32.4% had stage III, 31.1% had stage IV, and 18.9% had bone marrow involvement. The mean International Prognostic Index (IPI) score was 2.07 ± 1.67. R-CHOP was administered to 85.1% of patients, while 14.9% received R-EPOCH, and 5.4% were referred to other centers. Among the 25 deceased patients (33.8%), compared to the 49 survivors (66.2%), rural residency, unemployment, older age, presentation with B symptoms, stage IV disease, bone marrow involvement, triple-hit lymphoma, and higher IPI scores were significantly more common (p<0.05). In multivariable logistic regression analysis, rural residency (OR: 93.706, 95% CI: 1.789–4908.115, p=0.025) and higher IPI scores (OR: 18.595, 95% CI: 2.761–125.236, p=0.003) were identified as independent risk factors for mortality in DLBCL patients. Conclusion: This study demonstrated that rural residency and higher IPI scores are independent risk factors for mortality in DLBCL patients. Future multicenter prospective cohort studies with larger sample sizes and broader clinical parameters are needed to better define the risk factors associated with mortality in DLBCL.