Prognostic value of clinicopathological features of diffuse large B-cell lymphoma with bone marrow involvement

BackgroundDiffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma. The aim of this study was to comprehensively analyze the clinical, cytomorphological, and flow cytometry characteristics of DLBCL patients, with a focus on bone marrow involvement (BMI), to identify novel prognostic factors.MethodsThe clinical, cytomorphological, and flow cytometry characteristics of 220 DLBCL patients were collected from January 2017 to April 2024. Univariate and multivariate Cox regression analyses were performed to identify prognostic factors for overall survival (OS). Kaplan-Meier survival curves were generated. Logistic regression analyses were used to explore associations between clinical, cytomorphologic, and immunophenotyping features.ResultsThe median age of the patients was 63 years, with 48.6% showing positive BMI. Multivariate analysis confirmed that age, lactate dehydrogenase (LDH) level, hemoglobin (HGB) level, and platelet count (PLT) were independent prognostic factors for OS. Compared with patients without BMI, patients with BMI presented significant differences in laboratory parameters, such as lower lymphocyte counts and elevated inflammatory marker levels. Cytomorphological analysis of bone marrow smears revealed associations between specific cell characteristics (e.g., large cell size, medium cytoplasmic volume, and pseudopod protrusions) and immunophenotypic markers (e.g., CD23, CD79b, and cKappa).ConclusionAge, LDH, HGB, and PLT were identified as independent prognostic factors for OS. The integration of cytomorphological and flow cytometry data may provide additional insights into disease biology. Furthermore, this study highlighted that DLBCL patients with BMI have lower lymphocyte, PLT, and elevated levels of markers such as LDH, high-sensitivity C-reactive protein and β2-microglobulin.