Prognostic Impact of Inflammatory Biomarkers in Diffuse Large B-Cell Lymphoma: Analysis of a Cohort of 76 Patients

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Published Sep 13, 2026
https://doi.org/10.62438/tunismed.v104i08.5946
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Vol. 104 No. 08 (2026): Tunis Med Aug 2026

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Zaineb Mlayah
Department of Clinical Hematology,Hospital Fattouma Bourguiba, Faculty of Medicine of Monastir, University of Monastir, 5000, Monastir, Tunisia.
Ons Charef
Department of Clinical Hematology,Hospital Fattouma Bourguiba, Faculty of Medicine of Monastir, University of Monastir, 5000, Monastir, Tunisia.
Yasmine Bnouni
Department of Clinical Hematology,Hospital Fattouma Bourguiba, Faculty of Medicine of Monastir, University of Monastir, 5000, Monastir, Tunisia.
Nada Mabrouk
Department of Oncology, Hospital Fattouma Bourguiba, Faculty of Medicine of Monastir, University of Monastir, 5000, Monastir, Tunisia.
Ines Ben Rekaya
Department of Clinical Hematology,Hospital Fattouma Bourguiba, Faculty of Medicine of Monastir, University of Monastir, 5000, Monastir, Tunisia.
Inaam Bizid
Department of Clinical Hematology,Hospital Fattouma Bourguiba, Faculty of Medicine of Monastir, University of Monastir, 5000, Monastir, Tunisia.
Nader Slama
Department of Clinical Hematology,Hospital Fattouma Bourguiba, Faculty of Medicine of Monastir, University of Monastir, 5000, Monastir, Tunisia.
Sara Boukhris
Department of Clinical Hematology,Hospital Fattouma Bourguiba, Faculty of Medicine of Monastir, University of Monastir, 5000, Monastir, Tunisia.
Mohamed-Adnene Laatiri
Department of Clinical Hematology,Hospital Fattouma Bourguiba, Faculty of Medicine of Monastir, University of Monastir, 5000, Monastir, Tunisia.

Abstract

Introduction: Inflammation plays a key role in the progression of diffuse large B-cell lymphoma (DLBCL). Biomarkers such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) have been associated with prognosis in various malignancies. This study evaluates their prognostic impact in DLBCL.
Methods: We retrospectively analyzed 76 patients diagnosed with DLBCL. NLR, PLR, and SII were calculated before treatment. Associations with clinical and biological parameters were assessed using univariate analysis (Chi-square test). A multivariate analysis was performed using Cox regression to determine independent prognostic factors.
Results: Elevated PLR was significantly associated with higher performance status (PS) and increased lactate dehydrogenase (LDH) levels, which are known poor prognostic factors in DLBCL. However, in multivariate Cox regression analysis, PLR was not identified as an independent prognostic factor for survival. NLR and SII showed trends toward similar associations but did not reach statistical significance.
Conclusion: While PLR correlates with key clinical and biological indicators of disease severity, it does not appear to be an independent prognostic factor in DLBCL. Further studies with larger cohorts are needed to clarify its prognostic value.

Keywords:

Diffuse large B-cell lymphoma, Prognosis, Inflammation, Neutrophil-to-lymphocyte ratio, Platelet-to-lymphocyte ratio, Systemic immune-inflammation index

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