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. 2025 Dec 19:15:1689028.
doi: 10.3389/fonc.2025.1689028. eCollection 2025.

Prognostic factors of patients with intravascular large B cell lymphoma: a multicenter study in China

Yan Guo  1 , Yi Zhong  2 , Lixia Zhu  2 , Fengping Zhou  3 , Xuanru Lin  4 , Xian Li  5 , Xiufeng Wang  1 , Yan Huang  1 , Sun Wu  1 , Guoqing Lv  1 , Jinghang Zhang  6 , Yi Zhao  2 , Wenjun Wu  2 , Xiujin Ye  2 , Hanjin Yang  7 , Jin Zhang  3 , Kang Yu  4 , Yun Liang  5 , Zhen Cai  2 , Jingsong He  2
Affiliations

Prognostic factors of patients with intravascular large B cell lymphoma: a multicenter study in China

Yan Guo et al. Front Oncol. .

Abstract

Intravascular large B-cell lymphoma (IVLBCL) is a rare and highly aggressive lymphoma, but current knowledge is still inadequate. We retrospectively analyzed 50 IVLBCL patients from five Chinese tertiary hospitals in China between 2017 and 2024. Hemophagocytic variant (HV) patients showed worse performance status, universal B symptoms, more bone marrow infiltration, higher mortality, pancytopenia, elevated inflammatory markers (CRP, LDH, ferritin), hypoglobulinemia and hypogammaglobulinemia. Among 46 treated patients, CR/CRu rate was 71% (27/38). The 2-year OS was 65.5%, significantly worse in HV vs. classical variant (CV) (43.3% vs. 76.4%, P = 0.007). Multivariate analysis identified CNS involvement (HR = 10.86, P < 0.001), HV subtype (HR = 1.91, P = 0.018), and nodal organs involvement (HR = 5.26, P = 0.052) as poor prognostic factors. IVLBCL exhibits marked heterogeneity, with HV and CNS involvement conferring dismal outcomes. This study provides key diagnostic/therapeutic insights for IVLBCL in China, warranting prospective trials to validate prognostic models and optimize therapies.

Keywords: China; clinicopathological; intravascular large B-cell lymphoma; poor prognostic; treatment.

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Conflict of interest statement

The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
(A) H&E staining demonstrating vascular sinuses filled with lymphoma cells; (B) Immunohistochemical staining for CD20 is positive.
Figure 2
Figure 2
Overall survival of the entire IVLBCL cohort (n=50).
Figure 3
Figure 3
(A–C) Survival by (A) clinical subtype, (B) CNS involvement, and (C) nodal organs involvement.
Figure 4
Figure 4
(A–C) Survival by (A) globulin level, (B) D-dimer level, and (C) IgG level. Left to right follow by Figures 3A–C in first row. Left to right follow by (A–C) in the second row.
See this image and copyright information in PMC

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