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Updated: May 9, 2026
Application of Laparoscopic Partial Splenectomy with Total Blood Flow Occlusion in Benign Splenic Lesions
Published on: December 20, 2024
Enlarged splenic volume predicts poor survival and is associated with inflammatory imbalance in patients with diffuse
Zongjian Qiu1,2, Rifeng Jiang3, Shunquan Wu1,2
1Fujian Provincial Key Laboratory On Hematology, Fujian Institute of Hematology, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, People's Republic of China.
Purpose:
The spleen plays a significant role in innate and adaptive immunity. We aimed to evaluate the prognostic significance of the splenic volume in patients with diffuse large B-cell lymphoma (DLBCL), research on which is limited.
Methods:
We retrospectively analyzed 175 patients diagnosed with DLBCL. Based on optimal thresholds, patients were stratified into small (< 185 cm3), medium (185-315 cm3), and large (≥ 315 cm3) splenic volume groups. Survival analysis was performed using Kaplan-Meier and Cox proportional hazards model.
Results:
A significant decrease in progression-free survival (PFS) (P < 0.0001) and overall survival (OS) (P < 0.0001) was observed in the large group that received cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisone (CHOP) without or with rituximab (R-CHOP) treatment. Among the 139 patients who received R-CHOP, significant adverse effects on PFS (P < 0.0036) and OS (P < 0.0035) were observed in the large group. Univariate and multivariate analyses demonstrated that enlarged splenic volume (≥ 315 cm3) was associated with decreased PFS (P < 0.0001, P < 0.01, respectively) and OS (P < 0.001, P < 0.01, respectively). In terms of peripheral blood inflammatory markers, patients with enlarged splenic volume (≥ 315 cm3) exhibited lymphocytopenia, increased monocyte-to-lymphocyte ratio (MLR), increased neutrophil-to-lymphocyte ratio (NLR), and higher red blood cell distribution width (RDW) compared to that in those with smaller splenic volumes (P < 0.001, P < 0.001, P = 0.01, and P < 0.005, respectively).
Conclusion:
Splenic volume exceeding 315 cm3 is a poor prognostic factor for PFS and OS in patients with DLBCL. An enlarged splenic volume may be associated with compromised anti-cancer immune responses and aberrant inflammatory conditions.