Predictive Value of CRP, Albumin, CAR, and mGPS in Treatment Outcomes of DLBCL

Predictive Value of CRP, Albumin, CAR, and mGPS in DLBCL: A Prospective Cohort Study on Treatment Outcomes and Toxicity

This observational study evaluates the predictive value of systemic inflammatory markers-CRP, albumin, CRP-to-albumin ratio (CAR), and modified Glasgow Prognostic Score (mGPS)-in patients with diffuse large B-cell lymphoma (DLBCL) receiving R-CHOP chemotherapy. The study examines associations with treatment response, toxicity, and clinical characteristics.

This prospective cohort study investigates the predictive significance of systemic inflammatory markers-CRP, serum albumin, CRP-to-albumin ratio (CAR), and modified Glasgow Prognostic Score (mGPS)-in patients with diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP chemotherapy. The study aims to assess correlations between these markers and treatment outcomes, including objective response rate (ORR) and treatment-related toxicity. Inflammatory markers will be measured at baseline and after three chemotherapy cycles. Treatment response will be evaluated using Lugano classification criteria, and toxicity will be assessed per CTCAE version 5.0. The study also explores associations with clinical characteristics such as disease stage and performance status, aiming to enhance prognostic modeling and support personalized treatment strategies in DLBCL.

Inclusion Criteria:

• Age ≥ 18 years and ≤ 65 years
• Pathologically confirmed, treatment-naïve diffuse large B-cell lymphoma (DLBCL)
• Any stage of disease (nodal or extra-nodal), with or without B symptoms
• Scheduled to receive standard systemic treatment (R-CHOP)
• ECOG performance status 0-2
• Baseline normal:
• Complete blood count (CBC)
• Hepatitis viral markers
• Liver and renal function tests
• Urine analysis
• Echocardiogram
• Additional investigations to exclude current infection if clinically indicated

Exclusion Criteria:

• History of other concurrent or previous malignancies
• Relapsed or refractory DLBCL
• Uncontrolled comorbid conditions that may interfere with study participation, including:
• Diabetes mellitus
• Autoimmune diseases
• Active infections
• Chronic inflammatory diseases
• Cardiac dysfunction
• Liver cell failure
• Pregnant females