Zhao Dewan, Xu He, Tang Fengrao, Cui Tongcheng, Sun Xiuli, Song Guirong
Department of Hematology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
Department of Health Statistics, School of Public Health, Dalian Medical University, Dalian, Liaoning, China.
Front Oncol. 2025 Jun 16;15:1524498. doi: 10.3389/fonc.2025.1524498. eCollection 2025.
Diffuse Large B-Cell Lymphoma (DLBCL) is the most common subtype of Non-Hodgkin Lymphoma (NHL), with 20-40% of patients experiencing poor outcomes despite advancements in treatment. While Metabolic Syndrome (MetS) has been linked to NHL prognosis, its impact on DLBCL outcomes remains unclear.
This study examined the effects of dynamic changes in MetS components on DLBCL treatment outcomes and prognosis. We retrospectively analyzed 125 newly diagnosed DLBCL patients treated with 6-8 cycles of CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) or CHOP-like regimens, with or without rituximab, from May 2010 to May 2022. Group-based trajectory models were used to identify MetS component trajectories. Multivariate logistic regression and Cox proportional hazards regression were employed to determine factors affecting complete remission (CR), progression-free survival (PFS), and overall survival (OS).
The 2-year PFS and OS rates were 70.0% and 82.0%, respectively. High baseline high-density lipoprotein cholesterol (HDL-C) was associated with reduced progression risk (HR = 0.27, 95% CI: 0.10-0.78), while high baseline low-density lipoprotein cholesterol (LDL-C) was linked to decreased CR rate (OR = 0.65, 95% CI: 0.44-0.97) and increased progression risk (HR = 1.78, 95% CI: 1.14-2.79). Additionally, high LDL-C trajectory was associated with reduced CR rates, whereas moderate BMI trajectory was associated with improved CR, PFS, and OS.
Therefore, controlling LDL-C levels and maintaining a moderate BMI are crucial for improving DLBCL clinical outcomes.
弥漫性大B细胞淋巴瘤（DLBCL）是非霍奇金淋巴瘤（NHL）最常见的亚型，尽管治疗取得了进展，但仍有20%-40%的患者预后不佳。虽然代谢综合征（MetS）与NHL预后相关，但其对DLBCL预后的影响仍不清楚。
本研究探讨了MetS各组分的动态变化对DLBCL治疗效果和预后的影响。我们回顾性分析了2010年5月至2022年5月期间125例新诊断的DLBCL患者，这些患者接受了6-8个周期的CHOP（环磷酰胺、阿霉素、长春新碱和泼尼松）或类似CHOP的方案治疗，加或不加利妥昔单抗。基于组的轨迹模型用于识别MetS组分轨迹。采用多因素逻辑回归和Cox比例风险回归来确定影响完全缓解（CR）、无进展生存期（PFS）和总生存期（OS）的因素。
2年PFS率和OS率分别为70.0%和82.0%。高基线高密度脂蛋白胆固醇（HDL-C）与进展风险降低相关（HR = 0.27，95%CI：0.10-0.78），而高基线低密度脂蛋白胆固醇（LDL-C）与CR率降低相关（OR = 0.65，95%CI：0.44-0.97）和进展风险增加相关（HR = 1.78，95%CI：1.14-2.79）。此外，高LDL-C轨迹与CR率降低相关，而中度体重指数轨迹与CR改善、PFS和OS相关。
因此，控制LDL-C水平和维持适度的体重指数对改善DLBCL临床结局至关重要。
