Prognostic and clinicopathological impacts of systemic immune-inflammation index on patients with diffuse large B-cell lymphoma: a meta-analysis.

Abstract

The systemic immune-inflammation index (SII) represents the immunoinflammatory score and can be considered as a prognostic marker; however, its relevance to the prognosis in patients with diffuse large B-cell lymphoma (DLBCL) remains unclear. The present meta-analysis was conducted to comprehensively evaluate the relationship between the SII and prognosis in patients with DLBCL. This meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The PubMed, Web of Science, Embase, and Cochrane Library databases were comprehensively searched from inception to 16 March 2023. We calculated combined hazard ratios (HRs) and 95% confidence intervals (CIs) to estimate the prognostic significance of the SII for overall survival (OS) and progression-free survival (PFS) in DLBCL. In addition, this study determined odds ratios (ORs) and their 95% CIs to evaluate the correlation of SII with the clinicopathological features of DLBCL. Five articles including 592 cases were enrolled in the current meta-analysis. According to our combined findings, the higher SII significantly predicted worse OS (HR = 3.87, 95% CI: 2.48-6.04, p < 0.001) together with inferior PFS (HR = 2.38, 95% CI: 1.12-5.08, p = 0.024) in DLBCL. Furthermore, a high SII was significantly correlated with B symptoms (OR = 2.52, 95% CI: 1.66-3.81, p < 0.001), III-IV Ann Arbor stage (OR = 2.86, 95% CI: 1.84-4.45, p < 0.001), high-intermediate/high National Comprehensive Cancer Network International Prognostic Index (OR = 2.25, 95% CI: 1.52-3.31, p < 0.001), increased neutrophil-to-lymphocyte ratio (OR = 33.76, 95% CI: 17.18-66.35, p < 0.001), and increased platelet-to-lymphocyte ratio (OR = 44.65, 95% CI: 5.80-343.59, p < 0.001). Nonetheless, the SII was not significantly related to sex, age, lactic dehydrogenase level, Eastern Cooperative Oncology Group performance status, or histology. According to this meta-analysis, the higher SII dramatically predicted inferior OS and PFS of DLBCL. Furthermore, an increased SII significantly correlated with some clinicopathological features representing the disease progression of DLBCL. The protocol was registered in INPLASY under the number INPLASY202380106.