Prognostic significance of the CALLY index in patients with diffuse large B cell lymphoma

The C-reactive protein–Albumin–Lymphocyte (CALLY) index represents a newly introduced biomarker that combines parameters of immune regulation, nutrition, and systemic inflammation and it has been shown to forecast the course of the disease in some malignancies. This research aimed to investigate the prognostic significance of the CALLY index among individuals diagnosed with diffuse large B-cell lymphoma (DLBCL). A cohort of 112 patients diagnosed with DLBCL and managed at the Medical Faculty of Recep Tayyip Erdoğan University between January 2015 and August 2025 was reviewed retrospectively. Based on the determined CALLY index threshold, patients were classified into two distinct categories (<5.93 vs >5.93). A CALLY index below 5.93 was significantly related with the presence of B symptoms, older age, higher disease stage, extranodal involvement, poor Eastern Cooperative Oncology Group performance status (ECOG-PS), higher international prognostic index (IPI) scores, increased lactate dehydrogenase (LDH) levels, and increased mortality. In the univariate analysis performed from an overall survival (OS) perspective, disease stage, IPI score, albumin, C-reactive protein (CRP), ECOG-PS and CALLY index were identified as indicators of prognosis. In multivariate analysis, low CALLY index (<5.93) and ECOG-PS ≥ 2 continued to act as independent factors influencing OS (p=0.001 and p=0.01) Kaplan-Meier analysis revealed that patients exhibiting a CALLY index below 5.93 along with an IPI score of 3 or higher had markedly reduced progression-free survival (PFS) (p=0.049 and p=0.007) and OS (p<0.001 and p=0.005). Low CALLY index independently predicts OS in DLBCL and is linked to decreased PFS and OS durations. It can be considered a potential support tool for clinicians in their decision-making processes and prognosis predictions.