Prognostic value of multiple immune inflammatory markers in diffuse large B-cell lymphoma

Objective: To explore the prognostic value of multiple immune inflammatory indicators for diffuse large B-cell lymphoma (DLBCL). Methods: The clinical data of 175 patients with DLBCL who were diagnosed and received Immunochemotherapy in The Qinzhou First People's Hospital between January 2015 and December 2021 were retrospectively analyzed for this study. Patients were classified into a death group (n = 54) and a survival group (n = 121) depending on their prognosis. The clinical data of the patients with lymphocytes-to-beads (LMR), neutrophilsto-lymphocytes (NLR), and platelets-to-lymphocytes (PLR) were collected. The receiver operator characteristic curve (ROC) was used to determine the optimal critical value of the immune index. The Kaplan-Meier was used to draw the survival curve. The Cox regression model was used to analyze the factors affecting the prognosis of DLBCL. A nomogram risk prediction model was constructed to verify its effectiveness. Results: By the ROC curve analysis, the optimal cut-off value was 3.93 x 10(9)/L for neutrophil count, 2.42 for LMR, 23.6 mg/L for C-reactive protein (CPR), 2.44 for NLR, 0.67 x 10(9)/L for Monocyte, and 195.89 for PLR. The survival rate of patients with neutrophil number = 3.93 x 10(9)/L, LMR > 2.42, CRP <= 23.6 mg/L, NLR <= 2.44, Monocyte = 0.67 x 10(9)/L, PLR <= 195.89 was higher than that of patients with neutrophil number > 3.93 x 10(9)/L, LMR <= 2.42, CRP > 23.6 mg/L, NLR > 2.44, and Monocyte > 0.67 x 10(9)/L, PLR > 195.89. The nomogram was constructed based on the results of the multivariate analysis. The AUC of the nomogram was 0.962 (95% CI: 0.931-0.993) and 0.952 (95% CI: 0.883-1) in the training set and the test set, respectively. The calibration curve showed that the predicted value of the nomogram was in good agreement with the actual observed value. Conclusion: IPI score, neutrophil count, NLR, and PLR are risk factors impacting the prognosis of DLBCL. The combined prediction of IPI score, neutrophil count, NLR, and PLR can better reflect the prognosis of DLBCL. It can be used as a clinical index to predict the prognosis of diffuse large B-cell lymphoma, and provide clinical basis for improving the prognosis of patients.