ORIGINAL RESEARCH article
Front. Oncol.
Sec. Hematologic Malignancies
Prognostic Factors of Patients with Intravascular Large B Cell lymphoma: A Multicenter Study in China
Provisionally accepted
Yan Guo1
Yi Zhong2
Lixia ZHU2Fengping Zhou3Xuanru Lin4
Xian Li5
Xiufeng WANG1Yan Huang1Sun Wu1Guoqing Lv1
Jinghang Zhang6
Yi Zhao2Wenjun Wu2
Xiujin Ye2Hanjin Yang7
Jin Zhang3
Kang Yu8
Yun Liang5
Zhen Cai2
Jingsong He2*- 1Department of Hematology, First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
- 2Department of Hematology & Bone Marrow Transplantation Center, First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
- 3Department of Hematology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- 4Wenzhou Medical University First Affiliated Hospital Department of Hematology, Wenzhou, China
- 5Department of Hematology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- 6Department of Pathology,The First Affliated Hospital of XinXiang Medical University, Xinxiang, China
- 7Department of Pathology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- 8Department of Hematology, The First Affliated Hospital of Wenzhou Medical University, WenZhou, China
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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: Intravascular large B-cell lymphoma, Clinicopathological, Treatment, poor prognostic, China
Received: 19 Aug 2025; Accepted: 27 Nov 2025.
Copyright: © 2025 Guo, Zhong, ZHU, Zhou, Lin, Li, WANG, Huang, Wu, Lv, Zhang, Zhao, Wu, Ye, Yang, Zhang, Yu, Liang, Cai and He. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jingsong He
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