Prognostic impact of PM2.5 and components across multiple exposure windows in diffuse large B cell lymphoma

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 SO₄ ^2-, NO₃ ^-, NH₄ ⁺, OM, and BC, were estimated across four exposure windows of 1, 3, 5, and 10 years before diagnosis. OM averaged over 1 year (<i>HR</i> = 1.319; 95% CI: 1.035-1.681) and 5 years (<i>HR</i> = 1.325; 95% CI, 1.070-1.641), as well as SO₄ ^2- averaged over 3 years (<i>HR</i> = 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.