Poor prognostic impact of high serum ferritin levels in patients with a lower risk of diffuse large B cell lymphoma

The International Prognostic Index (IPI) and other prognostic models cannot accurately classify risks in patients with lower-risk diffuse large B cell lymphoma (DLBCL). This study retrospectively analyzed serum levels of ferritin (500 and ≥ 500 ng/mL) and other reported risk factors for survival in 312 patients. High and high-intermediate risk IPI scores (hazard ratio (HR) [95% confidence interval (CI)] 2.22 [1.33, 3.72], P = 0.002 and 2.29 [1.33, 3.93], P = 0.003, respectively) and ferritin concentration ≥ 500 ng/mL (HR [95% CI] 2.22 [1.37, 3.60], P = 0.001 and 2.18 [1.31, 3.63], P = 0.003, respectively) were independent poor prognostic factors for 5-year progression-free survival (PFS) and overall survival (OS) rates in all patients. Additionally, high ferritin level (≥ 500 ng/mL) was an independent poor prognostic factor for PFS and OS in patients with lower-risk IPI (HR [95% CI] 3.37 [1.36, 8.33], P = 0.009 and 3.29 [1.23, 8.83], P = 0.0018, respectively). In conclusion, serum ferritin levels may be helpful in predicting survival in patients with DLBCL, especially in those with lower-risk IPI scores.