Supplementary Material for: Title: Hans-based cell of origin is not of prognostic significance in DLBCL patients; Retrospective single center study conducted in 326 RCHOP treated patients

Background: Diffuse large B-cell lymphoma (DLBCL) is a highly aggressive lymphoma with dismal outcome after disease progression. Individual risk assessment can stratify patients into different treatment strategies.
Methods: We retrospectively collected data from 326 DLBCL patients treated in a single center with RCHOP from 01/2000 to 06/2023. Immunohistochemistry by Hans algorithm was used to classify patients according to cell of origin (COO). The Kaplan-Meier estimator of survival and Cox regression analysis were used.
Results: Time to progression (TTP) and overall survival (OS) were not different according to COO. Univariate analysis reveals international prognostic index (IPI), b2-microgloboulin ≥ 3,5 mg/L, bulky disease and abnormal LDH, but not Han’s defined COO, as the strongest predictors for progression. IPI score in multivariate analysis was the only prognostic factor for OS and together with high b2-microglobulin levels were independently prognostic factors for TTP. Accordingly, b2-microglobulin ≥ 3,5 mg/L was an independent prognostic factor for progression both in GC (HR 0,249 [(95% CI: 0,087-0,649), p=0,004] and non-GC DLBCL patients [HR 0,380 (95% CI: 0,177-0,813), p=0,011].
Conclusions: Cell of origin according to Hans Index is not a significant prognostic factor for DLBCL patients but b2 microglobulin ≥ 3,5 mg/L and IPI 2-5 in both GC and non-GC patients can predict individually a higher risk for progression.

背景：弥漫大B细胞淋巴瘤（DLBCL）是一类高度侵袭性淋巴瘤，疾病进展后预后不佳。个体化风险评估可将患者分层，进而制定差异化治疗策略。
方法：本研究回顾性收集了2000年1月至2023年6月间，单中心接受RCHOP方案治疗的326例DLBCL患者的临床资料。采用Hans分型法通过免疫组织化学染色对患者的细胞起源（COO）进行分型。统计分析采用Kaplan-Meier生存分析法与Cox回归模型。
结果：不同细胞起源（COO）分型患者的疾病进展时间（TTP）与总生存期（OS）均无显著差异。单因素分析显示，国际预后指数（IPI）、β2-微球蛋白（β2-microglobulin）≥3.5 mg/L、大肿块病变及乳酸脱氢酶（LDH）异常是疾病进展的最强预测因子，而Hans分型确定的COO分型则无此预测价值。多因素分析结果表明，IPI评分是总生存期（OS）的唯一独立预后因子；IPI评分联合高β2-微球蛋白水平则是疾病进展时间（TTP）的独立预后因子。进一步亚组分析显示，β2-微球蛋白≥3.5 mg/L在生发中心型（GC）DLBCL患者[风险比（HR）=0.249，95%置信区间（CI）：0.087~0.649，P=0.004]与非生发中心型（non-GC）DLBCL患者[HR=0.380，95%CI：0.177~0.813，P=0.011]中均为疾病进展的独立预后因子。
结论：基于Hans分型的细胞起源并非DLBCL患者的显著预后因子，但β2-微球蛋白≥3.5 mg/L以及IPI评分2~5分，在GC型与non-GC型DLBCL患者中均可独立预测更高的疾病进展风险。