A comprehensive analysis of B symptoms reveals prognosis and heterogeneity across different sites of diffuse large B-cell lymphoma

Diffuse large B-cell lymphoma (DLBCL) is a highly aggressive form of non-Hodgkin lymphoma. B symptoms, including fever, night sweats and weight loss, are often overlooked but carry prognostic significance. The primary site of DLBCL also plays a crucial role in diagnosis and treatment decisions, and our study aims to explore the relationship among primary sites of DLBCL, the presence of B symptoms and patients' survival. 15,267 patients' data were analyzed in our study to investigate the potential relevance among B symptoms, primary sites and patients' survival. We assessed the influence of primary site and B symptoms on survival with the use of Survival package and Kaplan-Meier survival analysis. Age, race and Ann-Arbor stage were significantly associated with the presence of B symptoms. The incidence rate of B symptoms varied across primary sites, bone marrow had the highest probability (43.75%), while the genital system had the lowest rate (13.58%). B symptoms were siginificant prognostic indicators among nodal DLBCL patients especially those involved lymph nodes of multiple regions, as well as patients with lymphoma originating from bone marrow, glands and respiration. Survival analysis revealed that bone marrow, genital organs, lymph nodes of multiple regions and head and neck are linked to poorer survival outcomes, which happen to be either the highest or lowest B symptom incidence sites. These findings highlight the prognostic importance of both primary tumor site and B symptom status in DLBCL patients.