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However, the association between cholesterol levels and diffuse large B cell lymphoma (DLBCL) remains unknown. The aim of our study was to evaluate the prognostic value of serum lipid profile in DLBCL. Five hundred and fifty enrolled subjects with detailed serum lipid levels at diagnosis of DLBCL were randomly divided into a training set (<jats:italic>n<\/jats:italic>\u2009=\u2009367) and a validation set (<jats:italic>n<\/jats:italic>\u2009=\u2009183) (ratio, 2:1). Multivariate Cox regression analyses screened the prognostic factors associated with progression\u2010free survival (PFS) and overall survival (OS). Performances of models were compared using C\u2010index and area under the curve in internal and external validation. The results showed that decreased levels of total cholesterol (TC), high\u2010density lipoprotein cholesterol (HDL\u2010C) and low\u2010density lipoprotein cholesterol (LDL\u2010C) were associated with unfavorable PFS and OS in the rituximab era, and concurrently low HDL\u2010C together with low LDL\u2010C was an independent prognostic indicator for both PFS and OS. Patients achieving complete remission or partial remission after 6\u20138 circles of chemotherapies had significantly increased cholesterol levels compared to the levels at DLBCL diagnosis, and HDL\u2010C or LDL\u2010C elevations were correlated with better survival. Furthermore, the predictive and discriminatory capacity of the National Comprehensive Cancer Network (NCCN)\u2010International Prognostic Index (IPI) together with low cholesterol levels was superior to NCCN\u2010IPI alone both in the training and validation set. In conclusion, serum cholesterol levels are simple and routinely tested parameters, which may be good candidates for predicting prognosis in the future clinical practice of DLBCL.<\/jats:p>","DOI":"10.1002\/ijc.31590","type":"journal-article","created":{"date-parts":[[2018,5,10]],"date-time":"2018-05-10T06:19:54Z","timestamp":1525933194000},"page":"1884-1895","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Low serum cholesterol levels predict inferior prognosis and improve NCCN\u2010IPI scoring in diffuse large B cell lymphoma"],"prefix":"10.1002","volume":"143","author":[{"given":"Rui","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Hematology The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Collaborative Innovation Center for Cancer Personalized Medicine Nanjing China"},{"name":"Department of Endocrinology The First Affiliated Hospital of Nanjing 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