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            <funder>This study was supported, in part, by the research funding from the National Natural Science Foundation of China (81325003, 81520108003, 81670716, and 81201863), Shanghai Commission of Science and Technology (14430723400, 14140903100, and 16JC1405800), National Key Research and Development Program (2016YFC0902800), Shanghai Municipal Education Commission Gaofeng Clinical Medicine Grant Support (20152206 and 20152208), multicenter clinical research project by Shanghai Jiao Tong University School of Medicine (DLY201601), SMC-Chen Xing Scholars Program, Chang Jiang Scholars Program, Interdisciplinary Program of Shanghai Jiao Tong University (YG2014QN6), Collaborative Innovation Center of Systems Biomedicine, and Samuel Waxman Cancer Research Foundation.</funder>
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                <title xml:lang="en">Pretreatment Liver Injury Predicts Poor Prognosis of DLBCL Patients</title>
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              <p>Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous group of lymphoma, with different clinical manifestation and prognosis. The International Prognostic Index (IPI), an index designed during the prerituximab era for aggressive lymphoma, showed variable values in the prediction of patient clinical outcomes. The aim of this study was to analyze the prognostic value and causes of pretreatment liver injury in 363 de novo DLBCL patients in our institution. Pretreatment liver impairment, commonly detected in lymphoma patients, showed significant association with poor outcomes and increased serum inflammatory cytokines in DLBCL patients but had no relation to hepatitis B virus replication nor lymphomatous hepatic infiltration. Multivariate analysis revealed that liver dysfunction, advanced Ann Arbor stage, and elevated lactate dehydrogenase (LDH) were independent adverse prognostic factors of both PFS and OS. Accordingly, a new liver-IPI prognostic model was designed by adding liver injury as an important factor in determining IPI score. Based on Kaplan-Meier curves for PFS and OS, the liver-IPI showed better stratification in DLBCL patients than either the IPI or the revised IPI in survival prediction.</p>
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