Prognostic Impact of Body Mass Index and Platelet to Lymphocyte Ratio in Patients with Diffuse Large B -Cell Lymphoma Primary Treated by R-CHOP

Taha, Heba F.; Kamel, Lamiaa Mahmoud Mohammed; Abdulbadea, Almustafa Ahmed; Waley, Ahmad Barakat

doi:10.21608/zumj.2025.414230.4114

Prognostic Impact of Body Mass Index and Platelet to Lymphocyte Ratio in Patients with Diffuse Large B -Cell Lymphoma Primary Treated by R-CHOP

Document Type : Original Article

Authors

¹ Professor of Medical Oncology, Faculty of Medicine - Zagazig University

² Professor of Clinical Pathology, Faculty of Medicine - Zagazig University

³ Resident Physician of Medical Oncology, Faculty of Medicine-Zagazig University

⁴ Lecturer of Medical Oncology, Faculty of Medicine, Zagazig University

10.21608/zumj.2025.414230.4114

Abstract

Background: Diffuse large B-cell lymphoma (DLBCL), the most common form of non-Hodgkin lymphoma, often requires refined risk assessment beyond the International Prognostic Index (IPI). This study investigated the prognostic significance of body mass index (BMI) and platelet-to-lymphocyte ratio (PLR) in patients receiving R-CHOP, aiming to enhance outcome prediction and support more tailored therapeutic strategies.

Methods: This retrospective cohort included 85 patients newly diagnosed with DLBCL who received R-CHOP between 2017 and 2022. Clinical presentation, laboratory findings, and therapeutic details were reviewed. Associations between various prognostic variables and treatment outcomes, including disease-free survival (DFS) and overall survival (OS), were evaluated.

Results: Complete response (CR) achieved in 74.1%, partial response among 2.4%, stable disease in 5.9 %, while progressive disease was encountered in 17.6%; and relapse occurred in 14.1% of patients who initially achieved CR. Median DFS was 25.5 months, and median OS was 31 months. At cutoff 126.7 PLR had sensitivity of 88%, and specificity of 66.7% with significant difference in predicting of response rate. PLR was significantly correlated with treatment response (p < 0.001), DFS (p = 0.002), and OS (p = 0.004). Patients with higher PLR had worse treatment and survival outcomes. The IPI was an independent predictor of response rate (p = 0.006), DFS (p = 0.001), and OS (p = 0.003).

Conclusion: Growing evidence highlights the prognostic relevance of pretreatment PLR in DLBCL, with its simplicity and low cost is useful adjunct to established prognostic models for identifying high-risk patients who might benefit from more aggressive treatment.

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