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This retrospective study evaluated the prognostic value of CAR in 186 DLBCL patients. A CAR value of 0.158 was selected as the most discriminative cut-off for identifying patients with high CAR values (73\/141 patients, 51.8%). During a median follow-up of 32.5\u00a0months, the high CAR group had significantly poorer complete response to induction therapy (64.4% vs. 92.6%; p\u2009&lt;\u20090.001), 3-year overall survival (OS) (68.3% vs. 96.2%; p\u2009&lt;\u20090.0001), and 3-year progression-free survival (PFS) (53.5% vs. 88.0%; p\u2009&lt;\u20090.0001). After adjusting for the International Prognostic Index components, a high CAR value independently predicted poor OS (HR: 6.02, 95% CI 1.19\u201330.38; p\u2009=\u20090.030) and PFS (HR: 3.62, 95% CI 1.40\u20139.36; p\u2009=\u20090.008). In an independent validation cohort (n\u2009=\u200950), patients with CAR\u2009&gt;\u20090.158 also showed worse 3-year OS (47.9% vs. 87.2%, p\u2009=\u20090.0035) and 3-year PFS (36.1% vs. 82.1%, p\u2009=\u20090.0011). A high CAR remained significantly associated with poor outcomes for\u2009&gt;\u200960-year-old patients (OS: p\u2009=\u20090.0038, PFS: p\u2009=\u20090.0015) and younger patients (OS: p\u2009=\u20090.0041, PFS: p\u2009=\u20090.0044). Among older patients, a high CAR value also predicted non-relapse mortality (p\u2009=\u20090.035). Therefore, the CAR might complement the International Prognostic Index in DLBCL cases.<\/jats:p>","DOI":"10.1038\/s41598-021-82087-6","type":"journal-article","created":{"date-parts":[[2021,1,29]],"date-time":"2021-01-29T06:19:10Z","timestamp":1611901150000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["High level of pre-treatment C-reactive protein to albumin ratio predicts inferior prognosis in diffuse large B-cell lymphoma"],"prefix":"10.1038","volume":"11","author":[{"given":"Jongheon","family":"Jung","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyewon","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ja Yoon","family":"Heo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myung Hee","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunyoung","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weon Seo","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ju-Hyun","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyeon-Seok","family":"Eom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,1,29]]},"reference":[{"key":"82087_CR1","doi-asserted-by":"publisher","first-page":"2375","DOI":"10.1182\/blood-2016-01-643569","volume":"127","author":"SH Swerdlow","year":"2016","unstructured":"Swerdlow, S. 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