J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://jocmr.elmerjournals.com

Original Article

Volume 18, Number 6, June 2026, pages 379-393

Baseline Lactate Dehydrogenase Predicts Early Treatment Failure in Diffuse Large B-Cell Lymphoma Treated With R-CHOP: A Real-World Cohort Study

↓ Figure 1. Flow diagram of patient selection and study cohort derivation. Patients diagnosed with DLBCL at Dharmais National Cancer Center Hospital between 2019 and 2024 were retrospectively screened from hospital medical records. The diagram shows sequential exclusions before cohort entry and before final analysis. The final analytic cohort consisted of 105 patients who initiated first-line R-CHOP at our center and had sufficient baseline and outcome data for early treatment failure classification. DLBCL: diffuse large B-cell lymphoma; R-CHOP: rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone.

↓ Figure 2. Discriminative performance of the multivariable logistic regression model for ETF in DLBCL (AUC = 0.646; 95% CI 0.540–0.752). The ROC curve demonstrates limited-to-modest discriminative ability of the model incorporating ECOG performance status, disease stage, anemia, LDH level, and age group. The AUC was 0.646 (95% CI 0.540–0.752; P = 0.010). AUC: area under the curve; CI: confidence interval; DLBCL: diffuse large B-cell lymphoma; ECOG: Eastern Cooperative Oncology Group; ETF: early treatment failure; LDH: lactate dehydrogenase; ROC: receiver operating characteristic.

↓ **Table 1.** Baseline Clinical Characteristics According to LDH Category
Variable	Overall cohort (n = 105)	Normal LDH ≤ 250 U/L (n = 37)	High LDH > 250 U/L (n = 68)	P value
LDH groups were defined using the institutional upper limit of normal: normal LDH ≤ 250 U/L and high LDH > 250 U/L. Continuous variables are presented as mean ± SD or median (IQR), depending on data distribution. Categorical variables are presented as number (percentage). Between-group p values are descriptive. BMI: body mass index; ECOG: Eastern Cooperative Oncology Group; IQR: interquartile range; LDH: lactate dehydrogenase; SD: standard deviation.
Age at diagnosis (years)	52.2 ± 13.4	52.5 ± 13.9	52.0 ± 13.2	0.863
Age group				0.684
Below 40	19 (18.1)	8 (21.6)	11 (16.2)
40–60	56 (53.3)	20 (54.1)	36 (52.9)
Above 60	30 (28.6)	9 (24.3)	21 (30.9)
Sex				0.656
Male	57 (54.3)	19 (51.4)	38 (55.9)
Female	48 (45.7)	18 (48.6)	30 (44.1)
Cancer in first-degree family member(s)				0.488
No	96 (91.4)	35 (94.6)	61 (89.7)
Yes	9 (8.6)	2 (5.4)	7 (10.3)
Diabetes mellitus				0.178
No	80 (76.2)	31 (83.8)	49 (72.1)
Yes	25 (23.8)	6 (16.2)	19 (27.9)
Hypertension				0.401
No	68 (64.8)	22 (59.5)	46 (67.6)
Yes	37 (35.2)	15 (40.5)	22 (32.4)
Cardiac disease				0.533
No	93 (88.6)	34 (91.9)	59 (86.8)
Yes	12 (11.4)	3 (8.1)	9 (13.2)
Hepatitis B				1.000
No	94 (89.5)	33 (89.2)	61 (89.7)
Yes	11 (10.5)	4 (10.8)	7 (10.3)
Hepatitis C				-
No	105 (100.0)	37 (100.0)	68 (100.0)
Yes	0 (0.0)	0 (0.0)	0 (0.0)
Chronic kidney disease				0.299
No	82 (78.1)	31 (83.8)	51 (75.0)
Yes	23 (21.9)	6 (16.2)	17 (25.0)
Chronic obstructive pulmonary disease				0.539
No	103 (98.1)	37 (100.0)	66 (97.1)
Yes	2 (1.9)	0 (0.0)	2 (2.9)
Human immunodeficiency virus infection				1.000
No	104 (99.0)	37 (100.0)	67 (98.5)
Yes	1 (1.0)	0 (0.0)	1 (1.5)
Number of comorbidities				0.110
0–1 comorbidity	72 (68.6)	29 (78.4)	43 (63.2)
Multiple comorbidities (> 1)	33 (31.4)	8 (21.6)	25 (36.8)
BMI (kg/m²)	21.8 (19.3–26.0)	21.2 (18.8–26.1)	21.9 (19.7–26.1)	0.415
BMI category				0.894
Underweight (< 18.5)	22 (21.0)	9 (24.3)	13 (19.1)
Normoweight (18.5–22.9)	38 (36.2)	13 (35.1)	25 (36.8)
Overweight (23.0–24.9)	13 (12.4)	5 (13.5)	8 (11.8)
Obese (≥ 25.0)	32 (30.5)	10 (27.0)	22 (32.4)
ECOG performance status				0.216
0	14 (13.3)	4 (10.8)	10 (14.7)
1	61 (58.1)	25 (67.6)	36 (52.9)
2	27 (25.7)	6 (16.2)	21 (30.9)
3	3 (2.9)	2 (5.4)	1 (1.5)
4	0 (0.0)	0 (0.0)	0 (0.0)
Ann Arbor stage at diagnosis				0.241
I	12 (11.4)	6 (16.2)	6 (8.8)
II	30 (28.6)	13 (35.1)	17 (25.0)
III	32 (30.5)	11 (29.7)	21 (30.9)
IV	31 (29.5)	7 (18.9)	24 (35.3)

↓ Table 1. Baseline Clinical Characteristics According to LDH Category

Variable

Overall cohort (n = 105)

Normal LDH ≤ 250 U/L (n = 37)

High LDH > 250 U/L (n = 68)

P value

LDH groups were defined using the institutional upper limit of normal: normal LDH ≤ 250 U/L and high LDH > 250 U/L. Continuous variables are presented as mean ± SD or median (IQR), depending on data distribution. Categorical variables are presented as number (percentage). Between-group p values are descriptive. BMI: body mass index; ECOG: Eastern Cooperative Oncology Group; IQR: interquartile range; LDH: lactate dehydrogenase; SD: standard deviation.

Age at diagnosis (years)

52.2 ± 13.4

52.5 ± 13.9

52.0 ± 13.2

0.863

Age group

0.684

Below 40

19 (18.1)

8 (21.6)

11 (16.2)

40–60

56 (53.3)

20 (54.1)

36 (52.9)

Above 60

30 (28.6)

9 (24.3)

21 (30.9)

Sex

0.656

Male

57 (54.3)

19 (51.4)

38 (55.9)

Female

48 (45.7)

18 (48.6)

30 (44.1)

Cancer in first-degree family member(s)

0.488

96 (91.4)

35 (94.6)

61 (89.7)

Yes

9 (8.6)

2 (5.4)

7 (10.3)

Diabetes mellitus

0.178

80 (76.2)

31 (83.8)

49 (72.1)

Yes

25 (23.8)

6 (16.2)

19 (27.9)

Hypertension

0.401

68 (64.8)

22 (59.5)

46 (67.6)

Yes

37 (35.2)

15 (40.5)

22 (32.4)

Cardiac disease

0.533

93 (88.6)

34 (91.9)

59 (86.8)

Yes

12 (11.4)

3 (8.1)

9 (13.2)

Hepatitis B

1.000

94 (89.5)

33 (89.2)

61 (89.7)

Yes

11 (10.5)

4 (10.8)

7 (10.3)

Hepatitis C

105 (100.0)

37 (100.0)

68 (100.0)

Yes

0 (0.0)

Chronic kidney disease

0.299

82 (78.1)

31 (83.8)

51 (75.0)

Yes

23 (21.9)

6 (16.2)

17 (25.0)

Chronic obstructive pulmonary disease

0.539

103 (98.1)

37 (100.0)

66 (97.1)

Yes

2 (1.9)

0 (0.0)

2 (2.9)

Human immunodeficiency virus infection

1.000

104 (99.0)

37 (100.0)

67 (98.5)

Yes

1 (1.0)

0 (0.0)

1 (1.5)

Number of comorbidities

0.110

0–1 comorbidity

72 (68.6)

29 (78.4)

43 (63.2)

Multiple comorbidities (> 1)

33 (31.4)

8 (21.6)

25 (36.8)

BMI (kg/m²)

21.8 (19.3–26.0)

21.2 (18.8–26.1)

21.9 (19.7–26.1)

0.415

BMI category

0.894

Underweight (< 18.5)

22 (21.0)

9 (24.3)

13 (19.1)

Normoweight (18.5–22.9)

38 (36.2)

13 (35.1)

25 (36.8)

Overweight (23.0–24.9)

13 (12.4)

5 (13.5)

8 (11.8)

Obese (≥ 25.0)

32 (30.5)

10 (27.0)

22 (32.4)

ECOG performance status

0.216

14 (13.3)

4 (10.8)

10 (14.7)

61 (58.1)

25 (67.6)

36 (52.9)

27 (25.7)

6 (16.2)

21 (30.9)

3 (2.9)

2 (5.4)

1 (1.5)

0 (0.0)

Ann Arbor stage at diagnosis

0.241

12 (11.4)

6 (16.2)

6 (8.8)

30 (28.6)

13 (35.1)

17 (25.0)

III

32 (30.5)

11 (29.7)

21 (30.9)

31 (29.5)

7 (18.9)

24 (35.3)

↓ **Table 2.** Baseline Hematological and Inflammatory Profile According to LDH Category
Variable	Overall cohort (n = 105)	Normal LDH ≤ 250 U/L (n = 37)	High LDH > 250 U/L (n = 68)	P value
LDH groups were defined using the institutional upper limit of normal: normal LDH ≤ 250 U/L and high LDH > 250 U/L. Continuous variables are presented as mean ± SD or median (IQR), depending on data distribution. Categorical variables are presented as number (percentage). Between-group P values are descriptive. P value for LDH itself is not shown because LDH was used as the grouping variable. ALC: absolute lymphocyte count; ANC: absolute neutrophil count; LMR: lymphocyte-to-monocyte ratio; IQR: interquartile range; LDH: lactate dehydrogenase; NLR: neutrophil-to-lymphocyte ratio; PLR: platelet-to-lymphocyte ratio; SD: standard deviation.
Hemoglobin level (g/dL)	12.0 ± 2.4	12.1 ± 2.1	11.9 ± 2.5	0.737
Anemia				0.317
Not anemic	47 (44.8)	19 (51.4)	28 (41.2)
Anemic (male < 13; female < 12)	58 (55.2)	18 (48.6)	40 (58.8)
Leukocyte count (× 10³/µL)	8.9 (5.8–11.6)	8.5 (4.9–10.6)	9.1 (6.4–11.9)	0.125
ANC (× 10³/µL)	5.8 (3.7–8.8)	5.3 (3.0–7.8)	6.1 (3.9–9.5)	0.073
ANC category				0.204
Low (< 1.5)	6 (5.7)	3 (8.1)	3 (4.4)
Normal (1.5–7.0)	59 (56.2)	24 (64.9)	35 (51.5)
High (> 7.0)	40 (38.1)	10 (27.0)	30 (44.1)
ALC (× 10³/µL)	1.6 ± 0.8	1.7 ± 0.9	1.5 ± 0.8	0.343
ALC category				0.939
Low (< 1.0)	26 (24.8)	9 (24.3)	17 (25.0)
Normal (≥ 1.0–4.8)	79 (75.2)	28 (75.7)	51 (75.0)
NLR	3.6 (2.2–7.0)	2.9 (2.0–5.9)	4.1 (2.5–7.6)	0.042
NLR category				0.013
≤ 3	40 (38.1)	20 (54.1)	20 (29.4)
> 3	65 (61.9)	17 (45.9)	48 (70.6)
LMR	2.2 (1.4–3.4)	2.3 (1.6–3.8)	2.1 (1.4–3.3)	0.294
LMR category				0.555
Low (< 2.5)	58 (55.2)	19 (51.4)	39 (57.4)
High (≥ 2.5)	47 (44.8)	18 (48.6)	29 (42.6)
PLR	205.3 (146.5–334.3)	186.3 (126.1–281.0)	231.1 (148.5–351.4)	0.216
PLR category				0.601
Normal (≤ 150)	28 (26.7)	11 (29.7)	17 (25.0)
High (> 150)	77 (73.3)	26 (70.3)	51 (75.0)
Platelet count (× 10³/µL)	325.0 ± 123.5	321.5 ± 110.1	326.9 ± 131.0	0.822
Platelet category				0.497
Thrombocytopenia (< 150)	6 (5.7)	1 (2.7)	5 (7.4)
Normal (150–450)	82 (78.1)	31 (83.8)	51 (75.0)
Thrombocytosis (> 450)	17 (16.2)	5 (13.5)	12 (17.6)

↓ Table 2. Baseline Hematological and Inflammatory Profile According to LDH Category

Variable

Overall cohort (n = 105)

Normal LDH ≤ 250 U/L (n = 37)

High LDH > 250 U/L (n = 68)

P value

LDH groups were defined using the institutional upper limit of normal: normal LDH ≤ 250 U/L and high LDH > 250 U/L. Continuous variables are presented as mean ± SD or median (IQR), depending on data distribution. Categorical variables are presented as number (percentage). Between-group P values are descriptive. P value for LDH itself is not shown because LDH was used as the grouping variable. ALC: absolute lymphocyte count; ANC: absolute neutrophil count; LMR: lymphocyte-to-monocyte ratio; IQR: interquartile range; LDH: lactate dehydrogenase; NLR: neutrophil-to-lymphocyte ratio; PLR: platelet-to-lymphocyte ratio; SD: standard deviation.

Hemoglobin level (g/dL)

12.0 ± 2.4

12.1 ± 2.1

11.9 ± 2.5

0.737

Anemia

0.317

Not anemic

47 (44.8)

19 (51.4)

28 (41.2)

Anemic (male < 13; female < 12)

58 (55.2)

18 (48.6)

40 (58.8)

Leukocyte count (× 10³/µL)

8.9 (5.8–11.6)

8.5 (4.9–10.6)

9.1 (6.4–11.9)

0.125

ANC (× 10³/µL)

5.8 (3.7–8.8)

5.3 (3.0–7.8)

6.1 (3.9–9.5)

0.073

ANC category

0.204

Low (< 1.5)

6 (5.7)

3 (8.1)

3 (4.4)

Normal (1.5–7.0)

59 (56.2)

24 (64.9)

35 (51.5)

High (> 7.0)

40 (38.1)

10 (27.0)

30 (44.1)

ALC (× 10³/µL)

1.6 ± 0.8

1.7 ± 0.9

1.5 ± 0.8

0.343

ALC category

0.939

Low (< 1.0)

26 (24.8)

9 (24.3)

17 (25.0)

Normal (≥ 1.0–4.8)

79 (75.2)

28 (75.7)

51 (75.0)

NLR

3.6 (2.2–7.0)

2.9 (2.0–5.9)

4.1 (2.5–7.6)

0.042

NLR category

0.013

≤ 3

40 (38.1)

20 (54.1)

20 (29.4)

> 3

65 (61.9)

17 (45.9)

48 (70.6)

LMR

2.2 (1.4–3.4)

2.3 (1.6–3.8)

2.1 (1.4–3.3)

0.294

LMR category

0.555

Low (< 2.5)

58 (55.2)

19 (51.4)

39 (57.4)

High (≥ 2.5)

47 (44.8)

18 (48.6)

29 (42.6)

PLR

205.3 (146.5–334.3)

186.3 (126.1–281.0)

231.1 (148.5–351.4)

0.216

PLR category

0.601

Normal (≤ 150)

28 (26.7)

11 (29.7)

17 (25.0)

High (> 150)

77 (73.3)

26 (70.3)

51 (75.0)

Platelet count (× 10³/µL)

325.0 ± 123.5

321.5 ± 110.1

326.9 ± 131.0

0.822

Platelet category

0.497

Thrombocytopenia (< 150)

6 (5.7)

1 (2.7)

5 (7.4)

Normal (150–450)

82 (78.1)

31 (83.8)

51 (75.0)

Thrombocytosis (> 450)

17 (16.2)

5 (13.5)

12 (17.6)

↓ **Table 3.** Treatment Response
Treatment response	Early treatment failure (n = 54)	Stays on remission^c (n = 51)
^aPrimary refractory disease was defined as: (1) stable disease or progressive disease occurring during first-line chemoimmunotherapy or by EOT, or (2) partial response as the best response at EOT. ^bEarly relapse was defined as relapse occurring within ≤ 12 months after achieving CR at EOT. ^cPatients classified as “stays on remission” achieved CR and had no evidence of relapse during follow-up. Patients without a failure event were administratively censored at 12 months. Data are presented as n (%) for categorical variables. CR: complete response; EOT: end of treatment; PD: progressive disease; PR: partial response; SD: stable disease.
CR	-	9 (100)	51 (100)
PR	22 (48.8)	-	-
SD	6 (13.4)	-	-
PD	17 (37.8)	-	-

↓ Table 3. Treatment Response

Treatment response

Early treatment failure (n = 54)

Stays on remission^c (n = 51)

Primary refractory disease^a (n = 45)

Early relapse^b (n = 9)

^aPrimary refractory disease was defined as: (1) stable disease or progressive disease occurring during first-line chemoimmunotherapy or by EOT, or (2) partial response as the best response at EOT. ^bEarly relapse was defined as relapse occurring within ≤ 12 months after achieving CR at EOT. ^cPatients classified as “stays on remission” achieved CR and had no evidence of relapse during follow-up. Patients without a failure event were administratively censored at 12 months. Data are presented as n (%) for categorical variables. CR: complete response; EOT: end of treatment; PD: progressive disease; PR: partial response; SD: stable disease.

9 (100)

51 (100)

22 (48.8)

6 (13.4)

17 (37.8)

↓ **Table 4.** Univariate Analysis
Variable	Outcome	OR (95% CI)	P value
*Statistically significant. ALC: absolute lymphocyte count; ANC: absolute neutrophil count; BMI: body mass index; CI: confidence interval; CKD: chronic kidney disease; COPD: chronic obstructive pulmonary disease; ECOG: Eastern Cooperative Oncology Group; HIV: human immunodeficiency virus; LDH: lactate dehydrogenase; LMR: lymphocyte to monocyte ratio; NLR: neutrophil to lymphocyte ratio; OR: odds ratio; PLR: platelet to lymphocyte ratio.
Age (years)
≤ 60	36 (48.0)	39 (52.0)	Ref	Ref
> 60	15 (50.0)	15 (50.0)	0.923 (0.396–2.153)	0.853
Sex
Male	28 (49.1)	29 (50.9)	Ref	Ref
Female	23 (47.9)	25 (52.1)	1.049 (0.487–2.263)	0.902
Cancer history in first-degree family
No	45 (46.9)	51 (53.1)	Ref	Ref
Yes	6 (66.7)	3 (33.3)	0.441 (0.104–1.867)	0.266
Diabetes mellitus
No	40 (50.0)	40 (50.0)	Ref	Ref
Yes	11 (44.0)	14 (56.0)	1.273 (0.516–3.140)	0.601
Hypertension
No	30 (44.1)	38 (55.9)	Ref	Ref
Yes	21 (56.8)	16 (43.2)	0.602 (0.268–1.349)	0.217
Heart disease
No	45 (48.4)	48 (51.6)	Ref	Ref
Yes	6 (50.0)	6 (50.0)	0.938 (0.282–3.120)	0.916
Hepatitis B
No	48 (51.1)	46 (48.9)	Ref	Ref
Yes	3 (27.3)	8 (72.7)	2.783 (0.695–11.140)	0.148
CKD
No	41 (50.0)	41 (50.0)	Ref	Ref
Yes	10 (43.5)	13 (56.5)	1.300 (0.512–3.299)	0.581
Comorbidity
0–1 comorbidity	34 (47.2)	38 (52.8)	Ref	Ref
Multiple comorbidities (> 1)	17 (51.5)	16 (48.5)	0.842 (0.369–1.921)	0.683
BMI (kg/m²)
Underweight (<18.5)	8 (36.4)	14 (63.6)	Ref	Ref
Not underweight (≥18.5)	43 (51.8)	40 (48.2)	0.532 (0.202–1.402)	0.201
ECOG score
Favorable ECOG (0–1)	42 (56.0)	33 (44.0)	Ref	Ref
Unfavorable ECOG (2–4)	9 (30.0)	21 (70.0)	2.970 (1.202–7.335)	0.018*
Stage at diagnosis
Limited-stage (I–II)	26 (61.9)	16 (38.1)	Ref	Ref
Advanced-stage (III–IV)	25 (39.7)	38 (60.3)	2.470 (1.108–5.506)	0.027*
Hemoglobin level (g/dL)
Not anemic	28 (59.6)	19 (40.4)	Ref	Ref
Anemic (male < 13; female < 12)	23 (39.7)	35 (60.3)	2.243 (1.023–4.916)	0.044*
ANC
Low–normal (≤ 7)	35 (53.8)	30 (46.2)	Ref	Ref
High (> 7)	16 (40.0)	24 (60.0)	1.750 (0.787–3.890)	0.170
ALC
Low (< 1)	10 (38.5)	16 (61.5)	Ref	Ref
Normal (≥ 1–4.8)	41 (51.9)	38 (48.1)	0.579 (0.234–1.432)	0.237
NLR
≤ 3	22 (55.0)	18 (45.0)	Ref	Ref
> 3	29 (44.6)	36 (55.4)	1.517 (0.687–3.350)	0.302
LMR
Low (< 2.5)	25 (43.1)	33 (56.9)	Ref	Ref
High (≥ 2.5)	26 (55.3)	21 (44.7)	0.612 (0.282–1.328)	0.214
PLR
Normal (≤ 150)	13 (46.4)	15 (53.6)	Ref	Ref
High (> 150)	38 (49.4)	39 (50.6)	0.889 (0.374–2.116)	0.791
Platelet count
Low to normal (≤ 450)	43 (48.9)	45 (51.1)	Ref	Ref
Thrombocytosis (> 450)	8 (47.1)	9 (52.9)	1.075 (0.380–3.042)	0.892
LDH
Normal (≤ 250)	24 (64.9)	13 (35.1)	Ref	Ref
High (> 250)	27 (39.7)	41 (60.3)	2.803 (1.220–6.439)	0.015*

↓ Table 4. Univariate Analysis

Variable

Outcome

OR (95% CI)

P value

Stay on remission

Early treatment failure (refractory and early relapse)

*Statistically significant. ALC: absolute lymphocyte count; ANC: absolute neutrophil count; BMI: body mass index; CI: confidence interval; CKD: chronic kidney disease; COPD: chronic obstructive pulmonary disease; ECOG: Eastern Cooperative Oncology Group; HIV: human immunodeficiency virus; LDH: lactate dehydrogenase; LMR: lymphocyte to monocyte ratio; NLR: neutrophil to lymphocyte ratio; OR: odds ratio; PLR: platelet to lymphocyte ratio.

Age (years)

≤ 60

36 (48.0)

39 (52.0)

Ref

> 60

15 (50.0)

0.923 (0.396–2.153)

0.853

Sex

Male

28 (49.1)

29 (50.9)

Ref

Female

23 (47.9)

25 (52.1)

1.049 (0.487–2.263)

0.902

Cancer history in first-degree family

45 (46.9)

51 (53.1)

Ref

Yes

6 (66.7)

3 (33.3)

0.441 (0.104–1.867)

0.266

Diabetes mellitus

40 (50.0)

Ref

Yes

11 (44.0)

14 (56.0)

1.273 (0.516–3.140)

0.601

Hypertension

30 (44.1)

38 (55.9)

Ref

Yes

21 (56.8)

16 (43.2)

0.602 (0.268–1.349)

0.217

Heart disease

45 (48.4)

48 (51.6)

Ref

Yes

6 (50.0)

0.938 (0.282–3.120)

0.916

Hepatitis B

48 (51.1)

46 (48.9)

Ref

Yes

3 (27.3)

8 (72.7)

2.783 (0.695–11.140)

0.148

CKD

41 (50.0)

Ref

Yes

10 (43.5)

13 (56.5)

1.300 (0.512–3.299)

0.581

Comorbidity

0–1 comorbidity

34 (47.2)

38 (52.8)

Ref

Multiple comorbidities (> 1)

17 (51.5)

16 (48.5)

0.842 (0.369–1.921)

0.683

BMI (kg/m²)

Underweight (<18.5)

8 (36.4)

14 (63.6)

Ref

Not underweight (≥18.5)

43 (51.8)

40 (48.2)

0.532 (0.202–1.402)

0.201

ECOG score

Favorable ECOG (0–1)

42 (56.0)

33 (44.0)

Ref

Unfavorable ECOG (2–4)

9 (30.0)

21 (70.0)

2.970 (1.202–7.335)

0.018*

Stage at diagnosis

Limited-stage (I–II)

26 (61.9)

16 (38.1)

Ref

Advanced-stage (III–IV)

25 (39.7)

38 (60.3)

2.470 (1.108–5.506)

0.027*

Hemoglobin level (g/dL)

Not anemic

28 (59.6)

19 (40.4)

Ref

Anemic (male < 13; female < 12)

23 (39.7)

35 (60.3)

2.243 (1.023–4.916)

0.044*

ANC

Low–normal (≤ 7)

35 (53.8)

30 (46.2)

Ref

High (> 7)

16 (40.0)

24 (60.0)

1.750 (0.787–3.890)

0.170

ALC

Low (< 1)

10 (38.5)

16 (61.5)

Ref

Normal (≥ 1–4.8)

41 (51.9)

38 (48.1)

0.579 (0.234–1.432)

0.237

NLR

≤ 3

22 (55.0)

18 (45.0)

Ref

> 3

29 (44.6)

36 (55.4)

1.517 (0.687–3.350)

0.302

LMR

Low (< 2.5)

25 (43.1)

33 (56.9)

Ref

High (≥ 2.5)

26 (55.3)

21 (44.7)

0.612 (0.282–1.328)

0.214

PLR

Normal (≤ 150)

13 (46.4)

15 (53.6)

Ref

High (> 150)

38 (49.4)

39 (50.6)

0.889 (0.374–2.116)

0.791

Platelet count

Low to normal (≤ 450)

43 (48.9)

45 (51.1)

Ref

Thrombocytosis (> 450)

8 (47.1)

9 (52.9)

1.075 (0.380–3.042)

0.892

LDH

Normal (≤ 250)

24 (64.9)

13 (35.1)

Ref

High (> 250)

27 (39.7)

41 (60.3)

2.803 (1.220–6.439)

0.015*

↓ **Table 5.** Multivariable Logistic Regression Analysis of All Prespecified Predictors for Early Treatment Failure
Variable	Adjusted OR (95% CI)	P value
*Statistically significant. Adjusted odds ratios were derived from a prespecified multivariable logistic regression model including age > 60 years, ECOG performance status, Ann Arbor stage, anemia, and LDH category. CI: confidence interval; ECOG: Eastern Cooperative Oncology Group; LDH: lactate dehydrogenase; OR: odds ratio.
Unfavorable ECOG (vs. 0–1)	2.228 (0.846–5.869)	0.105
Advanced stage III–IV (vs. I–II)	1.843 (0.782–4.341)	0.162
Anemia (vs. not anemia)	1.611 (0.684–3.797)	0.276
High LDH (vs. normal)	2.412 (1.006–5.785)	0.048*
Age > 60 (vs. ≤ 60)	0.888 (0.357–2.209)	0.799

↓ Table 5. Multivariable Logistic Regression Analysis of All Prespecified Predictors for Early Treatment Failure

Variable

Adjusted OR (95% CI)

P value

*Statistically significant. Adjusted odds ratios were derived from a prespecified multivariable logistic regression model including age > 60 years, ECOG performance status, Ann Arbor stage, anemia, and LDH category. CI: confidence interval; ECOG: Eastern Cooperative Oncology Group; LDH: lactate dehydrogenase; OR: odds ratio.

Unfavorable ECOG (vs. 0–1)

2.228 (0.846–5.869)

0.105

Advanced stage III–IV (vs. I–II)

1.843 (0.782–4.341)

0.162

Anemia (vs. not anemia)

1.611 (0.684–3.797)

0.276

High LDH (vs. normal)

2.412 (1.006–5.785)

0.048*

Age > 60 (vs. ≤ 60)

0.888 (0.357–2.209)

0.799