Prognostic impact of baseline immunologic profile in aggressive b-cell non-hodgkin's lymphomas

Safaa Ramadan, Giusy Ceparano, Alessandro Cignetti, Simona Sammassimo, Vincenzo Bagnardi, Eleonora Pagan, Daniela Gottardi, Stefano Fiori, Rita Passerini, Tommaso Radice, Giuseppe Saglio, Corrado Tarella

Research output: Contribution to journalArticlepeer-review


Host immune homeostasis as an independent prognostic indicator has been inadequately evaluated in aggressive non-Hodgkin's lymphomas (NHL). The present study addresses the prognostic significance in aggressive NHLs of the immunologic profile evaluated by pretreatment serum levels of immunoglobulins (Ig) and lymphocyte-monocyte ratio (LMR). In this series of 90 patients with aggressive lymphoma, the median level for IgG was 1,024mg/dl (range 436-2236), and for LMR was 2.2 (range 0.2-13.8). CR rate was higher with IgG levels ≥1,024mg/dL (91% vs 77% p=0.059). LMR ≤ 2.2 was associated with lower 1-year PFS (73% vs. 92%, p 0.016). Patients with good/very good R-IPI showed a reduced PFS if IgG or LMR was low, while patients with poor R-IPI did better if LMR or IgG levels were high. We combined both parameters with the R-IPI and produced a four-risk prognostic score showing one-year PFS of 95% (95% CI 68%-99%), 100% (95% CI 100%-100%), 73% (95% CI 52%-86%), and 59% (95% CI 31%-79%), in patients with zero, one, two and three risk factors, respectively. The results indicate for the first time the value of baseline serum Ig levels in the prognostic assessment of aggressive lymphoma.

Original languageEnglish
Article numbere2021018
JournalMediterranean Journal of Hematology and Infectious Diseases
Issue number1
Publication statusPublished - Mar 1 2021


  • Aggressive B-cell non-hodgkin's lymphoma
  • IGG
  • Immunologlobulin
  • Lymphocyte-monocyte ratio
  • Prognosis

ASJC Scopus subject areas

  • Hematology
  • Infectious Diseases


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